Labrina Jackson, SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SA13099 Issued in FL

Practice address

5401 S Kirkman Rd Ste 310
Orlando, FL 32819-7937

Phone

(866) 330-6427

NPI assigned

Mar 19, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL, GA2 enrollments

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Divine Deliverance Therapy Services, LLC

  • Speech-Language Pathologist
  • Orlando, FL
  • NPI 1730612185

  GA

  Medicare reassignment Authorized official

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

{
    "created_epoch": "1458345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1902267891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4630 S KIRKMAN RD STE 402",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328112833",
            "telephone_number": "407-719-3024",
            "fax_number": "866-330-6427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5401 S KIRKMAN RD STE 310",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328197937",
            "telephone_number": "866-330-6427"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6374 Vineland Rd Unit 105",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328197852",
            "country_code": "US",
            "telephone_number": "407-719-3024",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "LABRINA",
        "credential": "SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-19",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA13099",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karen Jackson
• Kasey Jackson, MD
• Katrina Elaine Jackson, RBT
• Kristin M. Jackson, M.D.
• Kristina Jackson
• Lauren Jackson
• Lawanda Jackson
• Leon Tremaine Jackson, COTA/L
• Lynn Michelle Jackson
• Mariah Jackson, CNM

• Speech-Language Pathologist in Orlando, FL
• Providers in Orlando, FL by specialty
• Speech-Language Pathologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.