Organization · Type 2 NPI

W.a. Foote Memorial Hospital

Psychiatry Physician · Jackson, MI

NPI number 1073547964 Active

Practice location

205 N East Ave
Jackson, MI 49201-1753

Call (517) 788-4800 Map

Mailing address

PO Box 670884
Detroit, MI 48267-2728

Specialties and licenses

Taxonomy	Code	License
Clinical Psychologist	103TC0700X	None listed
Social Worker	104100000X	None listed
Psychiatry Physician Primary	2084P0800X	None listed

Psychiatry Physician: A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic la…

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NPI record

NPI: 1073547964
Entity type: Organization (Type 2)
Issued: Jul 10, 2006
Last updated: Oct 22, 2026
Status: Active

Other names

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Allegiance Health · doing business as
Allegiance Health · doing business as
Henry Ford Jackson Health · doing business as

Authorized official

Kimberly Cebalt
Director
(313) 874-6764

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1073547964

W.a. Foote Memorial Hospital's National Provider Identifier is 1073547964, issued on Jul 10, 2006. The primary taxonomy on file is Psychiatry Physician (2084P0800X), and the practice location is in Jackson, MI. The record was last updated on Oct 22, 2026.