Jacqueline Mary Henretig
NPI 1316372139ActiveIndividual· Psychologist, Clinical· Tempe, AZ
Psychologist, Clinical in Tempe, Arizona, licensed in AZ, with an NPI issued in September 2013. Enrolled in Medicare as practitioner - clinical psychologist and practitioner - clinical psychologist.
Overview
| NPI | 1316372139 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Sole proprietor | No |
| NPI issued | Sep 11, 2013 |
| Last updated in NPPES | Aug 5, 2021 |
| Certified by provider | Aug 5, 2021 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Psychologist, Clinical Primary | 103TC0700X | PSY-005432 | AZ |
| Counselor, Mental Health | 101YM0800X | — | — |
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) | Enrolled Practitioner - Clinical Psychologist (AZ); Practitioner - Clinical Psychologist (CA) |
|---|
Education and affiliations
| Graduation year | 2016 |
|---|---|
| Medicare specialty | Clinical Psychologist |
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