Jacqueline Diane Parks, MA, TLLP
NPI 1194069500ActiveIndividual· Psychologist· Southgate, MI
Psychologist (MA, TLLP) in Southgate, Michigan, licensed in MI, with an NPI issued in November 2012.
Overview
| NPI | 1194069500 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | MA, TLLP |
| Sole proprietor | Yes |
| NPI issued | Nov 26, 2012 |
| Last updated in NPPES | Nov 26, 2012 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Psychologist Primary | 103T00000X | 6301015305 | MI |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
Other psychologists in Southgate
- 1053789891
- 1568552347
- 1437858198
- 1326825472
- 1477194769
- 1104534544
- 1467127118
- 1831632793
- 1437457413
- 1922124650
- 1255530234
- 1851934905
All 41 psychologists in Southgate · All psychologists in Michigan