Shelli S. Jackson, PHD, PLLC

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

922 Issued in OK

Legal business name

SHELLI S. JACKSON, PHD, PLLC

Practice address

2500 Boardwalk Ste 203
Norman, OK 73069-6593

Phone

(405) 329-8501

Fax

(405) 253-0581

NPI assigned

Dec 28, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Shelli S Jackson, PHD

Title

Manager

Phone

(405) 826-6528

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Raymond Henry McCaffrey Jr., PH.D.

  • Psychologist
  • Norman, OK
  • NPI 1184638272
  NPD
• Dwain A Pellebon, PHD, LCSW

  • Clinical Social Worker
  • Norman, OK
  • NPI 1720400351
  NPD

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

{
    "created_epoch": "1451260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639699200000",
    "number": "1760847255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 BOARDWALK STE 218",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730696664",
            "telephone_number": "405-329-8501",
            "fax_number": "405-253-0581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 BOARDWALK STE 203",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730696593",
            "telephone_number": "405-329-8501",
            "fax_number": "405-253-0581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHELLI S. JACKSON, PHD, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-28",
        "last_updated": "2021-12-17",
        "certification_date": "2021-12-17",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "SHELLI",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "405-826-6528",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Counseling",
            "state": "OK",
            "license": "922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eric Sheffield, RBT
• Gabrielle Sheffield, BHCMII
• Sondra Kay Shehab, MSW
• Shelba J Bethel MD Inc
• Debra Shell
• Latonya Lynn Shelton-Miller, D.D.S.
• George Allen Shelton Jr., PHD, MD
• Woodie Shepard Sr.
• Alexandria Leigh Shepherd
• Heather Dawn Shepherd, APRN-CNP

• Counseling Psychologist in Norman, OK
• Providers in Norman, OK by specialty
• Counseling Psychologist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2021; 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.