Dr Jessie M Maynard, LP, PSYD, CAADC is a medicare enrolled "Psychologist - Clinical" provider in Haslett, Michigan. His current practice location is
1199 Teakwood Cir, Haslett, Michigan. You can reach out to his office (for appointments etc.) via phone at
(202) 630-2790.
Dr Jessie M Maynard is licensed to practice in Michigan (license number 6301015286) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1710126750.
Healthcare Provider's Profile
| Full Name | Dr Jessie M Maynard |
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| Gender | Male |
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| Speciality | Psychologist - Clinical |
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| Location | 1199 Teakwood Cir, Haslett, Michigan |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1710126750
- Provider Enumeration Date: 02/15/2009
- Last Update Date: 05/12/2025
Medicare PECOS Information:
- PECOS PAC ID: 3072899244
- Enrollment ID: I20170425000701
Medical Identifiers
Medical identifiers for Dr Jessie M Maynard such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1710126750 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101YA0400X | Counselor - Addiction (substance Use Disorder) | C-00917 (Michigan) | Secondary |
| 101YM0800X | Counselor - Mental Health | 6301015286 (Michigan) | Secondary |
| 103TP2701X | Psychologist - Group Psychotherapy | 6301015286 (Michigan) | Secondary |
| 103TC0700X | Psychologist - Clinical | 6301015286 (Michigan) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Jessie M Maynard allows following entities to bill medicare on his behalf.
| Entity Name | Downriver Mental Health Clinic Pc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1295866135
PECOS PAC ID: 7911995139
Enrollment ID: O20040505000533 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Jessie M Maynard is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Dr Jessie M Maynard, LP, PSYD, CAADC
1199 Teakwood Cir,
Haslett, MI 48840-9734
Ph: (202) 630-2790 | Dr Jessie M Maynard, LP, PSYD, CAADC
1199 Teakwood Cir,
Haslett, MI 48840-9734
Ph: (202) 630-2790 |
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