Organization · Type 2 NPI

W.a. Foote Memorial Hospital

Clinical Psychologist · Jackson, MI

NPI number 1417494378 Active

Practice location

205 N. East Ave
Jackson, MI 49201

Call (517) 841-7843 Map

Fax (517) 841-7419

Mailing address

PO Box 670884
Detroit, MI 48267-0002

Specialties and licenses

Taxonomy	Code	License
Clinical Psychologist Primary	103TC0700X	1060000044 (MI)

Clinical Psychologist: A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of discip…

42 other providers at this address

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NPI record

NPI: 1417494378
Entity type: Organization (Type 2)
Issued: Jan 30, 2017
Last updated: Oct 22, 2026
Status: Active

Other names

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

Authorized official

Kimberly Cebalt
Director
(313) 874-6764

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About NPI 1417494378

W.a. Foote Memorial Hospital's National Provider Identifier is 1417494378, issued on Jan 30, 2017. The primary taxonomy on file is Clinical Psychologist (103TC0700X), and the practice location is in Jackson, MI. The record was last updated on Oct 22, 2026.