Dr. Edward L Jackson PSYD PLLC

Primary specialty

PsychologistTaxonomy code 103T00000X

Legal business name

DR. EDWARD L JACKSON PSYD PLLC

Practice address

2900 Welch Rd
Commerce TWP, MI 48390-1562

Phone

(248) 767-7927

NPI assigned

Jun 15, 2023

Last updated

Oct 7, 2026By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Stephanie Budry

Title

Practice Manager

Phone

(248) 376-2406

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Edward L Jackson, PSYD PLLC

  • Psychologist
  • Commerce TWP, MI
  • NPI 1043606213
  Medicare reassignment NPD
• Karen Brickner, M.A.

  • Psychologist
  • Fort Gratiot, MI
  • NPI 1912010315
  NPD (past)
• Shiloh Nevaeh Torres, TLLP

  • Clinical Psychologist
  • Commerce TWP, MI
  • NPI 1841982386
  NPD (past)
• Mauricemaria Umejiego

  • Mental Health Counselor
  • West Bloomfield, MI
  • NPI 1649960832
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1686787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1791331200000",
    "number": "1669156998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 WELCH RD",
            "city": "COMMERCE TWP",
            "state": "MI",
            "postal_code": "483901562",
            "telephone_number": "248-767-7927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 WELCH RD",
            "city": "COMMERCE TWP",
            "state": "MI",
            "postal_code": "483901562",
            "telephone_number": "248-767-7927"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5777 W Maple Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "West Bloomfield",
            "state": "MI",
            "postal_code": "483222268",
            "country_code": "US",
            "telephone_number": "248-831-0838",
            "fax_number": "947-251-5586",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DR. EDWARD L JACKSON PSYD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-15",
        "last_updated": "2026-10-07",
        "certification_date": "2026-10-07",
        "status": "A",
        "authorized_official_last_name": "BUDRY",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "248-376-2406"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in Commerce TWP, MI
• Providers in Commerce TWP, MI by specialty
• Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.