Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Jaclyn Reckow, PHD

Individual provider Clinical Neuropsychologist · NPI 1144717604

Jaclyn Reckow, PHD is a Clinical Psychologist in Grand Rapids, Michigan. Qualified in 2016, 10 years ago. Practices with Advantage Health/Saint Mary's Medical Group, a 494-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Michigan.

Years since qualifying
10
Licensed in
MI
In the registry since
2018
What do these letters mean?
PHD — Doctor of Philosophy
A research doctorate. In healthcare it usually sits alongside a clinical licence.

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Practice location Address checks out

245 Cherry St SE Ste 104
Grand Rapids, MI 49503-4607
Phone: (616) 685-5050
Fax: (616) 685-8962
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Neuropsychologist (primary) Taxonomy 103G00000X · Licence 6301016942 (MI)

Record details

NPI number1144717604
Entity typeIndividual (Type 1)
GenderFemale
Credentials PHD
Sole proprietorNo
NPI enumeratedApril 19, 2018
Last updated in NPPESApril 19, 2018
Mailing address1900 44th St Se, Kentwood, MI 49508-5008

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL PSYCHOLOGIST
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice Advantage Health/Saint Mary'S Medical Group — 494 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations4 on file with Medicare

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