Active NPI
Jenna Marie Gower
- Psychologist
- Troy, MI
National Provider Identifier
1952994857
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 6362009094
- Practice address
- 1777 Axtell Dr Ste 100
Troy, MI 48084-4400 - Phone
- (248) 787-0855
- NPI assigned
- Feb 11, 2021
- Sex
- Female
- Sole proprietor
- Yes
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 | 6362009094 | MI | Primary |
Addresses
Primary practice location
1777 Axtell Dr Ste 100
Troy, MI 48084-4400
Mailing address
525 Huntley Ave
Clawson, MI 48017-2319
Phone (269) 290-5537
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 |
|---|---|---|---|
| 6362009094 | MI | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1613001600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1613001600000",
"number": "1952994857",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "525 HUNTLEY AVE",
"city": "CLAWSON",
"state": "MI",
"postal_code": "480172319",
"telephone_number": "269-290-5537"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1777 AXTELL DR STE 100",
"city": "TROY",
"state": "MI",
"postal_code": "480844400",
"telephone_number": "248-787-0855"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOWER",
"first_name": "JENNA",
"middle_name": "MARIE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-02-11",
"last_updated": "2021-02-11",
"certification_date": "2021-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychologist",
"state": "MI",
"license": "6362009094",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Troy, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.