DR. LISA JACKSON (NPI# 1811012669) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811012669 |
| Entity Type | Individual |
| Full Name | DR. LISA JACKSON |
| Credential | PH.D. |
| Practice Address |
990 Route 146 Clifton Park NY 12065-3617 |
| Practice Telephone | 5185819525 |
| Mailing Telephone | 5182655264 |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2014-01-07 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103T00000X | Psychologist | 016988 | NY | Behavioral Health & Social Service Providers |
| Y | 103TB0200X |
Psychologist Specialization: Cognitive & Behavioral |
016988 | NY | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598300329 | Lisa Ann Jackson | Speech-Language Pathologist | 802 S Yucatan Dr, Tucson, AZ 85710-4933 | 2019-11-15 |
| 1194292441 | Lisa Jackson | Nurse's Aide | 2423 Montana Blue Dr, Spring, TX 77373-7871 | 2018-10-25 |
| 1770027781 | Lisa Jackson | Registered Nurse | 1520 E Calhoun St, Anderson, SC 29621-2210 | 2016-12-09 |
| 1154711166 | Lisa Jackson | Psychologist | 20111 Horace Harding Expy, Oakland Gardens, NY 11364-1639 | 2015-01-28 |
| 1720493224 | Lisa Nicole Jackson | Specialist/Technologist | 3200 Troup Hwy Ste, 120, Tyler, TX 75701 | 2014-06-24 |
| 1831468420 | Lisa Nicole Jackson | Licensed Practical Nurse | 1599 Prospect Pl Apt 1e, Brooklyn, NY 11233-4451 | 2011-12-28 |
| 1992023030 | Lisa Jackson | Massage Therapist | 7200 Sw 8th Ave Apt 9, Gainesville, FL 32607-1883 | 2010-05-13 |
| 1487844973 | Lisa Nicole Jackson | Obstetrics & Gynecology | 89-06 135th St, Room 6a, Jamaica, NY 11418 | 2007-07-31 |
| 1497828826 | Lisa Lanette Jackson | Nurse Practitioner | 1117 Chestnut St, Lewisville, AR 71845 | 2006-11-15 |
| 1972696516 | Lisa Thompson Jackson | Nurse Anesthetist, Certified Registered | 1500 E. Woodrow Wilson, Jackson, MS 39216 | 2006-10-02 |
| Street Address |
990 ROUTE 146 |
| City | CLIFTON PARK |
| State | NY |
| Zip Code | 12065-3617 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952372443 | Alicia Michele Sparano | Chiropractor | 990 Route 146, Clifton Park, NY 12065-3617 | 2006-01-31 |
| 1003080433 | Jessica Marie Moriarty | Acupuncturist | 990 Route 146, Clifton Park, NY 12065-3617 | 2008-04-16 |
| 1255537676 | Sparano Chiropractic Associates | Chiropractor | 990 Route 146, Clifton Park, NY 12065-3617 | 2007-06-22 |
| 1497727762 | Christopher Francis Sparano | Chiropractor | 990 Route 146, Clifton Park, NY 12065-3617 | 2006-02-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699395392 | Farah Malek | Pathology | 51 Heritage Point Drvie, Clifton Park, NY 12065 | 2020-04-22 |
| 1679116115 | Mary Beth Bulger | Registered Nurse | Shenendehowa Central School, 970 Rt 146, Clifton Park, NY 12065 | 2019-10-28 |
| 1346801636 | Terri Anne Willman | Physician Assistant | 1783 Route 9 Suite 102, Clifton Park, NY 12065 | 2019-06-26 |
| 1437633732 | Abhishek Chopra | Pharmacist | 74 Squire Lane, Clifton Park, NY 12065 | 2018-09-21 |
| 1295213817 | Ella Kotsyuba | Pharmacist | 1022 Ny-146, Clifton Park, NY 12065 | 2018-08-06 |
| 1659865962 | Dorothy Lacombe Adult Healthcare Nurse Practitioner Pllc | Internal Medicine | 954 Rt 146, Suite 3, Clifton Park, NY 12065 | 2018-06-20 |
| 1245723907 | Catherine Marie Blaauboer I | Licensed Practical Nurse | 206 Alnut Drive, Clifton Park, NY 12065 | 2018-06-07 |
| 1326530627 | Melissa Morgan | Physician Assistant | 29 Mann Blvd, Halfmoon, NY 12065 | 2018-06-01 |
| 1982101465 | Janelle Stannard | Occupational Therapist | 23 Sitterly Road, Clifton Park, NY 12065 | 2018-04-10 |
| 1962903831 | Clifton Park Asc LLC | Clinic/Center | 16 Maxwell Dr., Clifton Park, NY 12065 | 2018-02-26 |
| Find all providers in zip 12065 | ||||
| Taxonomy Code | 103TB0200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Cognitive & Behavioral |
| Definition to come... |
| Notes: [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538768916 | Shari Kohn | Psychologist | 20 Shadow Ln, Woodbury, NY 11797-2222 | 2020-10-18 |
| 1770180325 | Jonathan Rosen | Psychologist | 1760 2nd Ave Apt 18a, New York, NY 10128-5392 | 2020-10-07 |
| 1245837855 | Aunree J. Houston | Psychologist | 400 W 37th St Apt 10y, New York, NY 10018-5631 | 2020-10-06 |
| 1255944377 | Mindwell Center, LLP | Psychologist | 950 Danby Rd Ste 202f, Ithaca, NY 14850-5714 | 2020-08-28 |
| 1417575754 | Donato Vaccaro | Psychologist | 40 Deerfield Ave, Eastchester, NY 10709-3805 | 2020-07-13 |
| 1902432511 | Nancy Langdon | Psychologist | 410 Fort Salonga Rd, Northport, NY 11768-3046 | 2020-03-14 |
| 1386281376 | Grand Central Psychology Pllc | Psychologist | 50 E 42nd St Rm 1807, New York, NY 10017-5402 | 2019-12-09 |
| 1730722232 | Shimon N Littman | Psychologist | 495 W 187th St Apt 5e, New York, NY 10033-1521 | 2019-10-28 |
| 1821645367 | Rd Community Services LLC | Psychologist | 1049 38th St Ste B, Brooklyn, NY 11219-1012 | 2019-08-20 |
| 1881250041 | New Perspective Psychological Services | Psychologist | 1170a Ocean Ave, Brooklyn, NY 11230-1904 | 2019-05-14 |
| Find all providers with the same taxonomy | ||||
| City | CLIFTON PARK |
| Zip Code | 12065 |
Please comment or provide details below to improve the information on DR. LISA JACKSON.
| 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.