Lauren Innes Jackson, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

34654 Issued in TX

Practice address

5555 Arapaho Rd
Dallas, TX 75248-3442

Phone

(972) 661-1880

NPI assigned

Mar 9, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Jay Daniel Duhon, PH.D., PLLC

  • Clinical Neuropsychologist
  • Plano, TX
  • NPI 1902270630
  Medicare reassignment NPD
• Lauren I Jackson, PHD, PLLC

  • Clinical Psychologist
  • Dallas, TX
  • NPI 1649054743
  Medicare reassignment NPD
• Dr Associates of North Texas

  • Clinical Neuropsychologist
  • Plano, TX
  • NPI 1790050375
  NPD

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

{
    "created_epoch": "1331251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692921600000",
    "number": "1396010211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7810 AMHERST AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752258201",
            "telephone_number": "214-794-8507",
            "fax_number": "972-867-3402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5555 ARAPAHO RD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752483442",
            "telephone_number": "972-661-1880"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3351 Waterview Pkwy",
            "address_purpose": "LOCATION",
            "city": "Richardson",
            "state": "TX",
            "postal_code": "750801449",
            "country_code": "US",
            "telephone_number": "972-398-5700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5855 Milton St",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752064202",
            "country_code": "US",
            "telephone_number": "214-361-2214",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "LAUREN",
        "middle_name": "INNES",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-03-09",
        "last_updated": "2023-08-25",
        "certification_date": "2023-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "34654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kendall Claire Jackson
• Kevin Jackson Sr., CRNA
• Koben E Jackson
• Kymyatta Jackson
• Lara Lynn Jackson, FNP
• Leslie Aaron Jackson, D.C.
• Linda C Jackson, IBCLC, LCCE
• Linda Johnson Jackson, OD
• Lindsey Marie Jackson
• Lisa Jackson

• Clinical Psychologist in Dallas, TX
• Providers in Dallas, TX by specialty
• Clinical Psychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2023; 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.