Jessica Gardiner

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

6361008121 Issued in MI

Practice address

21800 Haggerty Rd Ste 207
Northville, MI 48167-8981

Phone

(248) 939-4021

NPI assigned

Oct 20, 2025

Sex

Unspecified or another gender identity

Sole proprietor

Yes

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

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

• Islamic Center of Detroit

  • Public Health or Welfare Agency
  • Detroit, MI
  • NPI 1578303095
  NPD (past)
• My Mental Wellness, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Detroit, MI
  • NPI 1437961513
  NPD (past)

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

{
    "created_epoch": "1760918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760918400000",
    "number": "1790652394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19376 SILVER SPRING DR APT 203",
            "city": "NORTHVILLE",
            "state": "MI",
            "postal_code": "481672569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21800 HAGGERTY RD STE 207",
            "city": "NORTHVILLE",
            "state": "MI",
            "postal_code": "481678981",
            "telephone_number": "248-939-4021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDINER",
        "first_name": "JESSICA",
        "sole_proprietor": "YES",
        "sex": "X",
        "enumeration_date": "2025-10-20",
        "last_updated": "2025-10-20",
        "certification_date": "2025-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6361008121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Full Circle Psychology, LLC
• Michael Funyak, PT
• Leyre Gainza
• Lindsay Gallagher, BS
• Robert Garcia, M.D.
• Samantha Jo Gardner, DPT, PT
• Jamie Garrison, LLMSW
• Denise Garshott, PAC
• Alexander Gates
• Jacqueline Gauvin, MS LLP

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2025; 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.