Active NPI
Jenny Jacqueline King, TLLP
- Psychologist
- Westland, MI
National Provider Identifier
1891829339
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 5301013221
- Practice address
- 8623 N Wayne Rd Ste 310
Westland, MI 48185-1137 - Phone
- (734) 425-0636
- NPI assigned
- Mar 15, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 5301013221 | MI | Primary |
Addresses
Primary practice location
8623 N Wayne Rd Ste 310
Westland, MI 48185-1137
Mailing address
11355 Eastside Dr
Plymouth, MI 48170-4330
Phone (805) 218-6002
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5301013221 | MI | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173916800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1891829339",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11355 EASTSIDE DR",
"city": "PLYMOUTH",
"state": "MI",
"postal_code": "481704330",
"telephone_number": "805-218-6002"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8623 N WAYNE RD STE 310",
"city": "WESTLAND",
"state": "MI",
"postal_code": "481851137",
"telephone_number": "734-425-0636"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KING",
"first_name": "JENNY",
"middle_name": "JACQUELINE",
"name_prefix": "Ms.",
"credential": "TLLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-15",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MI",
"license": "5301013221",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Westland, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.