Lois L Jackson, SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SLP008303 Issued in GA

Practice address

380 Lakeland Dr
Athens, GA 30607-2092

Phone

(706) 224-1178

NPI assigned

Feb 7, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Jackson Speech Therapy Services

  • Speech-Language Pathologist
  • Athens, GA
  • NPI 1003540261
  NPD Authorized official

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

{
    "created_epoch": "1391731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647043200000",
    "number": "1740604032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "380 LAKELAND DR",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306072092",
            "telephone_number": "706-224-1178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "380 LAKELAND DR",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306072092",
            "telephone_number": "706-224-1178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "LOIS",
        "middle_name": "L",
        "credential": "SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-02-07",
        "last_updated": "2022-03-12",
        "certification_date": "2022-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "109298",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WY",
            "license": "SP-1016",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP008303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cliff Jackson
• Elizabeth Jackson
• Hannah Jackson, LCSW
• Helen Jackson, MAT, MCD, CCC-SLP
• Larissa Jackson, MS
• Sarah Jackson
• Sarah Ellie Jackson, PSY.D.
• Sharon Jackson, CRNA
• Matthew Jacobson, PT, DPT, ATC
• Jacqueline Shaffer

• Speech-Language Pathologist in Athens, GA
• Providers in Athens, GA by specialty
• Speech-Language Pathologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2022; 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.