Jeffrey Brown Jackson, PH.D., LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

5731350-3902 Issued in UT

Practice address

450 N University Ave
Suite 204
Provo, UT 84601-2860

Phone

(801) 815-8105

NPI assigned

Jul 28, 2009

Last updated

Jul 28, 2009By the provider in NPPES

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1248739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248739200000",
    "number": "1447481205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1372 N 1230 W",
            "city": "OREM",
            "state": "UT",
            "postal_code": "840576512",
            "telephone_number": "801-815-8105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 N UNIVERSITY AVE",
            "address_2": "SUITE 204",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846012860",
            "telephone_number": "801-815-8105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "JEFFREY",
        "middle_name": "BROWN",
        "name_prefix": "Dr.",
        "credential": "PH.D., LMFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-07-28",
        "last_updated": "2009-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "UT",
            "license": "5731350-3902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brooke Jackson
• Brooklynn Jackson
• Emilee Jackson
• Haley W Jackson, MD
• Heather Kaye Jackson
• John W Jackson, M.D.
• Mark Aaron Jackson
• Megan Jackson
• Richard T Jackson, MD
• Richard Taylor Jackson II, MD

• Marriage & Family Therapist in Provo, UT
• Providers in Provo, UT by specialty
• Marriage & Family Therapist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 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.