Winnie Fong Jackson, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

6345 Issued in NC

Practice address

2817 Rock Merritt Ave
Fort Bragg, NC 28310-2540

Phone

(910) 907-6825

NPI assigned

Apr 12, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Winnie Fong Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1523491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747267200000",
    "number": "1467959759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2817 ROCK MERRITT AVE",
            "city": "FORT BRAGG",
            "state": "NC",
            "postal_code": "283105000",
            "telephone_number": "910-907-6825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2817 ROCK MERRITT AVE",
            "city": "FORT BRAGG",
            "state": "NC",
            "postal_code": "283102540",
            "telephone_number": "910-907-6825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "WINNIE",
        "middle_name": "FONG",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-12",
        "last_updated": "2025-05-15",
        "certification_date": "2025-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810007677",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "DC",
            "license": "PSYA00208",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NC",
            "license": "6345",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "WINNIE",
            "last_name": "FONG",
            "credential": "PSYD, HSP-P",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Amy L Jackson, P.A.
• Christopher Jackson, PARAMEDIC
• Claudia Jackson, PMHNP
• Edward Lawrence Jackson, PHARM.D.
• Robin Lashawn Jackson, NP-C
• Tara C Jacobs, RN
• Yazlyn Maria Jacobs, MSW, LCSW
• Maxwell Aaron Jakubowicz
• Simuel Lazaar Jamison, DMD
• Phillip Thomas Janssen, MPAS

• Clinical Psychologist in Fort Bragg, NC
• Providers in Fort Bragg, NC by specialty
• Clinical Psychologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2025; 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.