| Lauren I Jackson, Phd, Pllc | |
|
5555 Arapaho Rd Dallas TX 75248-3442 | |
| (972) 661-1880 | |
| Not Available |
| Full Name | Lauren I Jackson, Phd, Pllc |
|---|---|
| Speciality | Psychologist |
| Location | 5555 Arapaho Rd, Dallas, Texas |
| Authorized Official Name and Position | Christina Piering (BILLING MANAGER) |
| Authorized Official Contact | 4692361622 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lauren I Jackson, Phd, Pllc 7810 Amherst Ave Dallas TX 75225-8201 Ph: (214) 794-8507 | Lauren I Jackson, Phd, Pllc 5555 Arapaho Rd Dallas TX 75248-3442 Ph: (972) 661-1880 |
| NPI Number | 1649054743 |
|---|---|
| Provider Enumeration Date | 08/21/2023 |
| Last Update Date | 08/25/2023 |
| Certification Date | 08/25/2023 |
| Medicare PECOS PAC ID | 9234577230 |
|---|---|
| Medicare Enrollment ID | O20240410001534 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649054743 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Lauren Innes Jackson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1396010211 PECOS PAC ID: 6901052315 Enrollment ID: I20120816000820 |
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