DR. MICHELLE A JACKSON (NPI# 1346553021) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346553021 |
| Entity Type | Individual |
| Full Name | DR. MICHELLE A JACKSON |
| Credential | PH.D. |
| Practice Address |
2020 Peachtree Rd Nw Atlanta GA 30309-1426 |
| Practice Telephone | 4043671310 |
| Mailing Telephone | 4043507323 |
| Mailing Fax Number | 4043507694 |
| Enumeration Date | 2010-07-22 |
| Last Update Date | 2018-01-31 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103G00000X | Clinical Neuropsychologist | PSY004033 | GA | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | TUFTS | 685661 | 01 |
| MA | 110026265E | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104434067 | Michelle Jackson | Behavior Technician | 6961 Rooks Ct Apt 305, Frederick, MD 21703-2781 | 2020-07-16 |
| 1790347722 | Michelle Lynn Jackson | Family Medicine | 456 Circle Dr, Kewanee, IL 61443-3622 | 2019-06-29 |
| 1396301487 | Michelle Jackson | Technician | 14000 Castle Blvd Apt 703, Silver Spring, MD 20904-4640 | 2019-05-14 |
| 1184196685 | Michelle Maria Jackson | Health Educator | 220 E 89th St, Brooklyn, NY 11236-1418 | 2018-12-20 |
| 1396253258 | Michelle Laray Jackson | Counselor | 3765 Carisbrook Dr, North Las Vegas, NV 89081-6631 | 2018-01-12 |
| 1427509173 | Michelle Jackson | Behavioral Analyst | 115 Franklin St Ne Apt H21, Washington, DC 20002-1091 | 2016-10-18 |
| 1891193678 | Michelle Jackson | Occupational Therapy Assistant | 12611 Hickman Pl, Denver, CO 80239-6204 | 2014-12-10 |
| 1215338330 | Michelle Jackson | Nurse Practitioner | 115 Fields St # De, Mooresville, IN 46158-1492 | 2014-09-08 |
| 1699058008 | Michelle A Jackson | Occupational Therapist | 6045 Ashford Ln, Unit 102, Naples, FL 34110-2416 | 2011-09-21 |
| 1285923185 | Michelle Ann Jackson | Rehabilitation Practitioner | 7124 Diving Petrels Pl, 7124 Diving Petrels Pl, North Las Vegas, NV 89084-2353 | 2011-03-31 |
| Street Address |
2020 PEACHTREE RD NW |
| City | ATLANTA |
| State | GA |
| Zip Code | 30309-1426 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831188929 | Michael Robert Yochelson | Neuromusculoskeletal Medicine & OMM | 2020 Peachtree Rd Nw, Atlanta, GA 30309-1426 | 2005-10-20 |
| 1447865803 | Laura Ko | Pharmacist | 2020 Peachtree Rd Nw, Atlanta, GA 30309-1426 | 2020-09-12 |
| 1386264430 | Tori Le | Occupational Therapist | 2020 Peachtree Rd Nw, Atlanta, GA 30309-1426 | 2020-04-19 |
| 1063043347 | Joy Williams | Physical Therapist | 2020 Peachtree Rd Nw, Atlanta, GA 30309-1426 | 2020-01-27 |
| 1679036370 | Katherine Long Mccauley | Psychologist | 2020 Peachtree Rd Nw, Atlanta, GA 30309-1465 | 2019-04-09 |
| 1295296226 | William Alexander Alverson | Clinical Neuropsychologist | 2020 Peachtree Rd Nw, Atlanta, GA 30309-1465 | 2019-03-31 |
| 1467930446 | Conekia Marshea Kinsey | Nurse Practitioner | 2020 Peachtree Rd Nw, Atlanta, GA 30309-1426 | 2018-08-01 |
| 1275054157 | Beverly Bonilla | Nurse Practitioner | 2020 Peachtree Rd Nw, Atlanta, GA 30309-1426 | 2017-06-30 |
| 1497283584 | Sara Ann Schleicher-dilks | Clinical Neuropsychologist | 2020 Peachtree Rd Nw, Atlanta, GA 30309-1426 | 2017-06-01 |
| 1306387972 | Stephanie Polk | Clinical Nurse Specialist | 2020 Peachtree Rd Nw, Atlanta, GA 30309-1426 | 2017-03-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396382354 | Astoria Dentistry LLC | Dentist | 2233 Peachtree Rd. Nw, Suite 300, Atlanta, GA 30309 | 2019-12-09 |
| 1487133740 | S2 Telehealth Technologies, LLC | Psychiatry & Neurology | 915 W Peachtree St Nw Apt 522, Atlanta, GA 30309 | 2018-08-08 |
| 1841782620 | Janie Mardis | Social Worker | 3 Park Ln Ne, Apt H, Atlanta, GA 30309 | 2018-06-06 |
| 1083102842 | Veronica L Bentley | Specialist/Technologist, Other | 1170 Peachtree Street Suite 1200, Atlanta, GA 30309 | 2018-04-27 |
| 1427566363 | Net Medical Corp | Chiropractor | 1100 Spring St Sw, Ste#700, Atlanta, GA 30309 | 2018-01-12 |
| 1871000463 | Mary James (jamie) Johnson | Counselor | 1100 Spring Street, Suite 380, Atlanta, GA 30309 | 2018-01-04 |
| 1306377817 | Aliyah Lamis Scott | Social Worker | 1745 Peachtree Road Ne, Kaiser Permanente Brookwood Medical Office, Atlanta, GA 30309 | 2017-03-26 |
| 1013450774 | Caroline Hallen | Nurse Practitioner | 105 Collier Rd Nw Suite 3040, Atlanta, GA 30309 | 2016-11-29 |
| 1528501723 | Ant-aging Queen | Nutritionist | 1801 Atlanta Medical Clinic, Suite 250, Atlanta, GA 30309 | 2016-11-21 |
| 1790231439 | Nurse 2 Health Home Care LLC | Home Health | 1075 Peachtree Street Ne, Atlanta, GA 30309 | 2016-09-01 |
| Find all providers in zip 30309 | ||||
| Taxonomy Code | 103G00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Clinical Neuropsychologist |
| An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |
| Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720614746 | Neuropsychology Associates of Georgia LLC | Clinical Neuropsychologist | 280 Interstate North Cir Se Ste 450, Atlanta, GA 30339-2451 | 2020-03-21 |
| 1023586773 | The Atlanta Psychology Group | Clinical Neuropsychologist | 3500 Piedmont Rd Ne Ste 740, Atlanta, GA 30305-1507 | 2018-11-09 |
| 1053850172 | S. Marilyn Miller | Clinical Neuropsychologist | 90 Fairlie St Nw, Suite 203, Atlanta, GA 30303-2127 | 2017-02-22 |
| 1457898371 | Tamara Weiss, M.d., LLC | Clinical Neuropsychologist | 1772 Century Blvd Ne Ste A, Atlanta, GA 30345-3396 | 2017-01-30 |
| 1689048076 | Laura Blackwell | Clinical Neuropsychologist | 5455 Meridian Marks Rd Ste 180, Atlanta, GA 30342-4716 | 2015-11-23 |
| 1306287412 | Negar Fani | Clinical Neuropsychologist | 101 Woodruff Cir Ste 4304, Atlanta, GA 30322-0001 | 2013-07-17 |
| 1629383799 | Aimilia Papazoglou | Clinical Neuropsychologist | 5825 Glenridge Dr Ste 1-133, Atlanta, GA 30328-7144 | 2010-08-13 |
| 1700113883 | Laura Lee Hoskins | Clinical Neuropsychologist | 2020 Peachtree Nw Rd, Atlanta, GA 30309-1426 | 2009-11-10 |
| 1831329077 | Dawn Linnea Ilardi | Clinical Neuropsychologist | 5455 Meridian Marks Rd Ne Ste 180, Atlanta, GA 30342-4716 | 2009-07-22 |
| 1174707756 | Catherine Hillary Rogers | Clinical Neuropsychologist | 280 Interstate North Cir Se, Suite 450, Atlanta, GA 30339-2450 | 2007-12-19 |
| Find all providers in ATLANTA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.