J Flack Psyd PC
NPI 1770859001ActiveOrganization· Psychologist· Fenton, MI
Psychologist in Fenton, Michigan, registered in NPPES in March 2012. The authorized official on file is Jennifer Flack, PSY.D., LP, President. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1770859001 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Mar 30, 2012 |
| Last updated in NPPES | Jan 22, 2025 |
| Certified by provider | Jan 22, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Psychologist Primary | 103T00000X | 6301014240 | MI |
| Counselor | 101Y00000X | 6401006094 | MI |
| Social Worker | 104100000X | 6801006671 | MI |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (MI) |
|---|
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