Javel Jackson, PSYD

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

002284 Issued in GA

Practice address

4360 Chamblee Dunwoody Rd
Suite 530
Atlanta, GA 30341-1049

Phone

(770) 630-6843

NPI assigned

Feb 18, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Dr. Javel Jackson Long Other name

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1171756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1316081706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 374457",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300374457",
            "telephone_number": "770-630-6843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4360 CHAMBLEE DUNWOODY RD",
            "address_2": "SUITE 530",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303411049",
            "telephone_number": "770-630-6843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "JAVEL",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-18",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "002284",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "002009",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAVEL",
            "last_name": "LONG",
            "middle_name": "JACKSON",
            "prefix": "DR.",
            "credential": "PSYD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Elijah Jackson
• Eunika Jackson
• Imani Jackson
• Jabari Jackson
• Jamita Jackson
• Jeanine Angela Jackson, AU.D., CCC-A
• Jenna Marie Jackson
• Jennifer A Jackson, MD
• Jennifer Chantel Jackson, MBA
• Jennifer Jacqueline Jackson, PA

• Professional Counselor in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.