Valerie Darice Jackson, PH D

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

36604 Issued in TX

Practice address

3730 Kirby Dr Ste 904
Houston, TX 77098-3994

Phone

(832) 484-2635

Fax

(832) 202-2479

NPI assigned

Apr 5, 2012

Last updated

Apr 6, 2018By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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

• The Adolescent Center and Mental Health Services, PLLC

  • Clinical Psychologist
  • Houston, TX
  • NPI 1578953857
  Authorized official Same address or phone

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

{
    "created_epoch": "1333584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522972800000",
    "number": "1538425392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3730 KIRBY DR STE 904",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770983994",
            "telephone_number": "832-484-2635",
            "fax_number": "832-202-2479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3730 KIRBY DR STE 904",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770983994",
            "telephone_number": "832-484-2635",
            "fax_number": "832-202-2479"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3730 Kirby Dr",
            "address_2": "SUITE 1200",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770983905",
            "country_code": "US",
            "telephone_number": "832-484-2635",
            "fax_number": "713-831-6896",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "VALERIE",
        "middle_name": "DARICE",
        "credential": "PH D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-05",
        "last_updated": "2018-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "36604",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "162342304",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Teniola Yetunde Jackson
• Thanesha Jackson
• Tiffani Theressa Jackson
• Timothy A. Jackson, M.D. PHD
• Tonia Lynette Jackson, FNP-C
• Velma L. Jackson, P.T.
• Vickie Jackson, PH.D.
• Jacksons & J. K. Pharmacy L.L.C
• Beatrice Jacky, LBSW
• Jaclyn Harrison, MD, PLLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2018; 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.