Dr Winnie Fong Jackson, PSYD is a
Psychologist - Clinical based in Fort Liberty, North Carolina. Dr Winnie Fong Jackson is licensed to practice in North Carolina (license number 6345) and her current practice location is
2817 Rock Merritt Ave Stop A, Fort Liberty, North Carolina. She can be reached at her office (for appointments etc.) via phone at
(910) 907-6825.
NPI number for Dr Winnie Fong Jackson is 1467959759 and her current mailing address is 3113 Golden Nugget Dr, Clayton, North Carolina. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1467959759.
Healthcare Provider's Profile
| Full Name | Dr Winnie Fong Jackson |
|---|
| Gender | Female |
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| Speciality | Psychologist - Clinical |
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| Location | 2817 Rock Merritt Ave Stop A, Fort Liberty, North Carolina |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1467959759
- Provider Enumeration Date: 04/12/2018
- Last Update Date: 02/04/2025
Medical Identifiers
Medical identifiers for Dr Winnie Fong Jackson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1467959759 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YM0800X | Counselor - Mental Health | PSYA00208 (District Of Columbia) | Secondary |
| 103TC0700X | Psychologist - Clinical | 0810007677 (Virginia) | Secondary |
| 103TC0700X | Psychologist - Clinical | 6345 (North Carolina) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Winnie Fong Jackson is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Winnie Fong Jackson, PSYD
3113 Golden Nugget Dr,
Clayton, NC 27520-8052
Ph: (510) 908-2173 | Dr Winnie Fong Jackson, PSYD
2817 Rock Merritt Ave Stop A,
Fort Liberty, NC 28310-2540
Ph: (910) 907-6825 |
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