Jennifer L. Jackson, PHD

Clinical Psychologist · Summit, NJ

Individual Active NPI

NPI number 1336360247

Practice location

35 Deforest Ave
Summit, NJ 07901-2155
Phone
(917) 685-4207

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NPI record

NPI
1336360247
Entity type
Individual (Type 1)
Enumeration date
May 1, 2007
Last updated
July 15, 2010
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Clinical Psychologist Primary 103TC0700X 016536 NY
Clinical Child & Adolescent Psychologist 103TC2200X 016536 NY
Family Psychologist 103TF0000X 016536 NY

About Dr. Jackson

Jennifer L. Jackson, PHD is a healthcare provider registered in the NPI registry with the primary taxonomy Clinical Psychologist (code 103TC0700X). The practice location is 35 Deforest Ave, Summit, NJ 07901-2155. The NPI number 1336360247 was assigned on May 1, 2007 and the record was last updated on July 15, 2010.

Dr. Jackson lists 3 licenses in the registry: #016536 (NY) for Clinical Psychologist; #016536 (NY) for Clinical Child & Adolescent Psychologist; #016536 (NY) for Family Psychologist. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Jennifer L. Jackson, PHD?

The NPI number is 1336360247.

What is the phone number of Dr. Jackson?

The phone number listed for the practice location is (917) 685-4207.

Where is Dr. Jackson located?

35 Deforest Ave, Summit, NJ 07901-2155.

What is the taxonomy code for Dr. Jackson?

The primary taxonomy code is 103TC0700X – Clinical Psychologist; 2 more listed above.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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