Melissa Jackson, PH.D.

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

018244 Issued in NY

Practice address

29 W Fulton St Ste D
Gloversville, NY 12078-2937

Phone

(518) 313-6105

NPI assigned

Jul 12, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Melissa Carmel Former 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

Specialty

Clinical Psychologist

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Locations

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 Psychological, PLLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Gloversville, NY
  • NPI 1043072622
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1184198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713744000000",
    "number": "1912106733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 W FULTON ST STE D",
            "city": "GLOVERSVILLE",
            "state": "NY",
            "postal_code": "120782937",
            "telephone_number": "518-313-6105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 W FULTON ST STE D",
            "city": "GLOVERSVILLE",
            "state": "NY",
            "postal_code": "120782937",
            "telephone_number": "518-313-6105"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "106 Mohawk Ave",
            "address_purpose": "LOCATION",
            "city": "Scotia",
            "state": "NY",
            "postal_code": "123022248",
            "country_code": "US",
            "telephone_number": "517-313-6105",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "MELISSA",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-12",
        "last_updated": "2024-04-22",
        "certification_date": "2024-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "NY",
            "license": "018244",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "CARMEL",
            "prefix": "DR.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Dorothy Hughes
• Kristen M Hunt, LCSW
• Paul Joseph Husson Jr., M.D.
• Syed Iqbal, MD
• Jackson Psychological, PLLC
• Jodi Beth Jacques, M.S.
• Richard Joseph Jankunas Jr., DC
• John L Glenn MD
• John M. Fox D.D.S.
• Barbara Jean Johnson, LPN

• Counseling Psychologist in Gloversville, NY
• Providers in Gloversville, NY by specialty
• Counseling Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.