NPIMap

Organization Active NPI

Lisa Jackson, PHD & Associates

  • Psychologist
  • Halfmoon, NY
National Provider Identifier
1760857056
Registry record updated Dec 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
LISA JACKSON, PHD & ASSOCIATES
Practice address
1745 Route 9
Halfmoon, NY 12065-2470
Phone
(518) 371-2210
NPI assigned
Dec 11, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2015

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

Authorized official

Name
Lisa JacksonNPI 1811012669
Title
Licensed Psychologist
Phone
(518) 265-5264

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X Primary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X

Addresses

Primary practice location

1745 Route 9
Halfmoon, NY 12065-2470

Mailing address

1745 Route 9
Halfmoon, NY 12065-2470

National Provider Directory

National Provider Directory

Locations

1745 Route 9
Halfmoon, NY 12065
Phone (518) 265-5264

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1449792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1449792000000",
    "number": "1760857056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1745 ROUTE 9",
            "city": "HALFMOON",
            "state": "NY",
            "postal_code": "120652470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1745 ROUTE 9",
            "city": "HALFMOON",
            "state": "NY",
            "postal_code": "120652470",
            "telephone_number": "518-371-2210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LISA JACKSON, PHD & ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-11",
        "last_updated": "2015-12-11",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "LICENSED PSYCHOLOGIST",
        "authorized_official_telephone_number": "518-265-5264"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Halfmoon, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 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.