Ashley Jackson, PH.D.

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

MFT001368 Issued in GA

Practice address

3785 Town Square Cir NW
Kennesaw, GA 30144-2377

Phone

(334) 707-2634

NPI assigned

Jan 2, 2015

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 names 1

• Ashley Anders Former name

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": "1420156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420156800000",
    "number": "1629466313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3785 TOWN SQUARE CIR NW",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301442377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3785 TOWN SQUARE CIR NW",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301442377",
            "telephone_number": "334-707-2634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "ASHLEY",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-01-02",
        "last_updated": "2015-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "GA",
            "license": "MFT001368",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ASHLEY",
            "last_name": "ANDERS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Maha Islam
• Lindsey Isley
• Madison Margaret Iuliano, DC
• J Marseille Management, Inc.
• Amber Kay Jackson, DC
• Breiane Jackson, LICENSED CPHT
• Darryl Maurice Jackson
• Jadah Jackson
• Joi Jackson
• Regina Michelle Jackson, LCSW

• Marriage & Family Therapist in Kennesaw, GA
• Providers in Kennesaw, GA by specialty
• Marriage & Family Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2015; 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.