Alexandria Jerichow, MA, TLLP

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

630101787 Issued in MI

Practice address

42500 Hayes Rd Ste 500
Clinton Township, MI 48038-6768

Phone

(586) 828-1221

NPI assigned

May 23, 2019

Last updated

May 23, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://app.meldrx.com/api/fhir/pimsy-thrive

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.

• Growth Mindset Therapeutic Services, PLLC

  • Clinical Psychologist
  • Shelby Township, MI
  • NPI 1598563140
  NPD Authorized official
• Thrive Behavioral Health

  dba Thrive Behavioral Health of Michigan

  • Clinical Psychologist
  • Shelby Township, MI
  • NPI 1245667443
  NPD (past)

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

{
    "created_epoch": "1558569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558569600000",
    "number": "1902463169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8505 CHESTERFIELD DR",
            "city": "SWARTZ CREEK",
            "state": "MI",
            "postal_code": "484731272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42500 HAYES RD STE 500",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480386768",
            "telephone_number": "586-828-1221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JERICHOW",
        "first_name": "ALEXANDRIA",
        "credential": "MA, TLLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-23",
        "last_updated": "2019-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "630101787",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "14473184",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "CAQH",
            "affiliation": "N",
            "address_1": "42500 Hayes Rd Ste 500",
            "city": "Clinton Township",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480386768",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Vera Jay, DPT
• Dorothy Gail Jazowski, LMSW
• Tiffany Jeffers
• Veronica Jenei, PMHNP-BC
• In Sik Jeon, M.D.
• Drew William Jerome, DDS
• Harjeet Singh Jhajj, D.O.
• Carolee Ann Joachim-Sam, LMSW
• Joak American Homes, Inc.
• Michael M Joh, M.D.

• Clinical Psychologist in Clinton Township, MI
• Providers in Clinton Township, MI by specialty
• Clinical Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2019; 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.