DR. MICHELLE A JACKSON PH.D. NPI 1346553021

NPI Information

NPI: 1346553021
Provider Name: DR. MICHELLE A JACKSON, PH.D.
Classification: Clinical Neuropsychologist - 103G00000X
Entity Type: Individual
Organization: SHEPHERD CENTER, INC.

PECOS Registration: Yes

Address:
2020 PEACHTREE RD NW
ATLANTA, GA
ZIP 30309
Phone: (404) 367-1310
Get Directions

DR. Michelle A Jackson, PH.D. is a clinical neuropsychologist in Atlanta, GA with 10 years of experience. The provider is a clinical psychologist who applies principles of assessment and intervention based upon the scientific study of human behavior as it relates to normal and abnormal functioning of the central nervous system. The specialty is dedicated to enhancing the understanding of brain-behavior relationships and the application of such knowledge to human problems. DR. Michelle A Jackson, PH.D. NPI is 1346553021. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2020 PEACHTREE RD NW
ATLANTA, GA
ZIP 30309-426
Phone: (404) 367-1310

The NPI 1346553021 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment.

The enumeration date for this NPI number is 7/22/2010 and was last updated on 1/31/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	103G00000X	Clinical Neuropsychologist		PSY004033	GEORGIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	685661	OTHER	MASSACHUSETTS	TUFTS
2	110026265E	MEDICAID	MASSACHUSETTS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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