Dana Jamal Jackson, PSYD.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

016903 Issued in NY

Practice address

7510 91St Ave
Woodhaven, NY 11421-2824

Phone

(718) 298-2671

Fax

(718) 296-4660

NPI assigned

May 21, 2008

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

Other names 1

• Dr. Dana Jamal Jackson Professional name

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dana.jackson.1@22829.direct.athenahealth.com

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

• The Floating Hospital Inc.

  • Federally Qualified Health Center (FQHC)
  • Long Island City, NY
  • NPI 1306954631
  Medicare reassignment NPD
• Supportive Care Psychology of Ny PC

  • Clinical Psychologist
  • Howell, NJ
  • NPI 1104315068

  NY

  Medicare reassignment NPD
• The Floating Hospital Inc.

  • Federally Qualified Health Center (FQHC)
  • Brooklyn, NY
  • NPI 1275946550
  NPD
• The Floating Hospital Inc.

  • Federally Qualified Health Center (FQHC)
  • Long Island City, NY
  • NPI 1851704530
  NPD

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

{
    "created_epoch": "1211328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376870400000",
    "number": "1720245194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7510 91ST AVE",
            "city": "WOODHAVEN",
            "state": "NY",
            "postal_code": "114212824",
            "telephone_number": "847-977-0609",
            "fax_number": "718-927-9398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7510 91ST AVE",
            "city": "WOODHAVEN",
            "state": "NY",
            "postal_code": "114212824",
            "telephone_number": "718-298-2671",
            "fax_number": "718-296-4660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "DANA",
        "middle_name": "JAMAL",
        "name_prefix": "Dr.",
        "credential": "PSYD.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-05-21",
        "last_updated": "2013-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "016903",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DANA",
            "last_name": "JACKSON",
            "middle_name": "JAMAL",
            "prefix": "DR.",
            "credential": "PSYD.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Muhammad Imran, RPH
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• Daisy Isern, COTA/L
• Nashid Islam, PA
• Tasnim M Islam, LCSW
• Jamaica 18 Dentistry P.C.
• Jamira Santiago
• JBKM, LLC
• Helen L Joe, RD
• Joel Schwitzer DMD PC

• Clinical Psychologist in Woodhaven, NY
• Providers in Woodhaven, NY by specialty
• Clinical Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.