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NPI Code Detail

MEDICARE: JACKSON BEHAVIORAL SERVICES

MEDICARE: JACKSON BEHAVIORAL SERVICES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical Psychologist6301010119MI
2103TC0700XClinical Psychologist6302006268MI
3261QM1300XMulti-Specialty Clinic/Center4301044183MI
4261QM2500XMedical Specialty Clinic/Center4301044183MI

General Provider Information

NPI Number : 1306957444
Entity Type Code : Organization
Provider Name (Legal Business Name) : JACKSON BEHAVIORAL SERVICES
Provider Business Mailing Address
First Line : 209 E WASHINGTON AVE
Second Line : SUITE 221
City : JACKSON
State : MI
Zip : 49201-2393
Country : US
Telephone Number : 517-780-0809
Fax Number : 517-788-5922
Provider Business Practice Location Address
First Line : 209 E WASHINGTON AVE
Second Line : SUITE 221
City : JACKSON
State : MI
Zip : 49201-2393
Country : US
Telephone Number : 517-780-0809
Fax Number : 517-788-5922
Authorized Official
Title or Position : PSYCHOLOGIST
Name : MR. BRADLEY L SCHWEDA
Credential : LLP
Telephone Number : 517-780-0809
Provider Enumeration Date : 08/31/2006
Last Update Date : 09/11/2025

Similar Medicare Providers

1588642110 — GREAT LAKES HOME HEALTH SERVICES, INC.
Practice Location Address:
209 E WASHINGTON AVE STE 450
JACKSON, MI
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1568440055 — GREAT LAKES HOME HEALTH SERVICES, INC.
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1952988370 — GREAT LAKES HOME HEALTH SERVICES, INC.
Practice Location Address:
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JACKSON, MI
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Practice Fax: 517-780-9700
1578564852 — GREAT LAKES MEDICAL EQUIPMENT, INC.
Practice Location Address:
209 E WASHINGTON AVE STE 254
JACKSON, MI
49201-2393
Practice Phone: 517-536-7350
Practice Fax: 517-536-0671
1629244033 — BRADFORD J BANDEMER
Practice Location Address:
209 E WASHINGTON AVE , SUITE 220
JACKSON, MI
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1063650414 — RAMONA SUE WRIGHT L.P.C.
Practice Location Address:
209 E WASHINGTON AVE , SUITE 219 BOX 6
JACKSON, MI
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Practice Phone: 517-262-0571
Practice Fax: 866-904-2399

Directions to “JACKSON BEHAVIORAL SERVICES ” Practice Location

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