Jacob Samuel Chmara, LLP

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

6361007813 Issued in MI

Practice address

1603 E 9 Mile Rd
Ferndale, MI 48220-2065

Phone

(248) 514-4955

NPI assigned

Sep 6, 2019

Last updated

Mar 20, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Emotional Advantage LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Ferndale, MI
  • NPI 1447647789
  NPD

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

{
    "created_epoch": "1567728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710892800000",
    "number": "1770132300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23551 ONEIDA ST",
            "city": "OAK PARK",
            "state": "MI",
            "postal_code": "482373701",
            "telephone_number": "248-330-4129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1603 E 9 MILE RD",
            "city": "FERNDALE",
            "state": "MI",
            "postal_code": "482202065",
            "telephone_number": "248-514-4955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHMARA",
        "first_name": "JACOB",
        "middle_name": "SAMUEL",
        "credential": "LLP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-09-06",
        "last_updated": "2024-03-20",
        "certification_date": "2024-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6361007813",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deena Chabaan, PA-C
• Thomas Champion
• Emily Jean-Peden Chase, LLC, ATR-P
• Cheri Chenet
• Melissa Renee Chivis, LMSW
• Shuhrat Shakil Choudhury
• Alandra D Chuney
• City of Ferndale (Ferndale Fire Department)
• Clarity Clinic LLC
• Matthew Daniel Clinton

• Clinical Psychologist in Ferndale, MI
• Providers in Ferndale, MI by specialty
• Clinical Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.