Bayside Psychological Services LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

BAYSIDE PSYCHOLOGICAL SERVICES LLC

Practice address

273 Azalea Rd Ste 305
Mobile, AL 36609-1970

Phone

(251) 599-3728

NPI assigned

Jun 22, 2009

Last updated

Jun 22, 2009By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Jennifer M Jackson, PSYDNPI 1598789695

Title

Clinical Psychologist

Phone

(251) 599-3728

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jennifer McCall Jackson, PSY.D.

  • Clinical Psychologist
  • Mobile, AL
  • NPI 1598789695
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1245628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1245628800000",
    "number": "1124256789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "273 AZALEA RD STE 305",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366091970",
            "telephone_number": "251-599-3728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "273 AZALEA RD STE 305",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366091970",
            "telephone_number": "251-599-3728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAYSIDE PSYCHOLOGICAL SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-22",
        "last_updated": "2009-06-22",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "251-599-3728",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Bayside Sitters
• Bayview Wellness, LLC
• BC OBGYN LLC
• Be Well Clinic of Mobile LLC
• Ashlyn P Beach, RBT

• Community/Behavioral Health Agency in Mobile, AL
• Providers in Mobile, AL by specialty
• Community/Behavioral Health Agency in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.