Akua Jackson, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

5720 Issued in NC

Practice address

2634 Durham Chapel Hill Blvd Ste 220
Durham, NC 27707-2877

Phone

(919) 288-8993

NPI assigned

May 15, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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

{
    "created_epoch": "1526342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734220800000",
    "number": "1669962650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5306 NC HIGHWAY 55 STE 105",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277137812",
            "telephone_number": "919-457-1517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2634 DURHAM CHAPEL HILL BLVD STE 220",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277072877",
            "telephone_number": "919-288-8993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "AKUA",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-15",
        "last_updated": "2024-12-15",
        "certification_date": "2024-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NC",
            "license": "5720",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan Izatt
• J. Stuart McCracken, M.D., P.a.
• Kevin Jack, DC
• Jamillah A. Jackson Kelly, MS/EDS, NCC, LCMHCS
• Jackson Odondi
• Alexandra Megan Jackson, CPNP
• Ashton Jackson, RDN
• Bethena M Jackson, CSAC, LCAS-A
• Brooke A Jackson, MD
• Carrie Ann Jackson, M.ED

• Clinical Psychologist in Durham, NC
• Providers in Durham, 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 Dec 15, 2024; 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.