Mrs Kelly Green Jackson, SLP - Speech-Language Pathologist in Lake Park, GA

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Mrs Kelly Green Jackson, SLP is a Speech-language Pathologist based in Lake Park, Georgia. Mrs Kelly Green Jackson is licensed to practice in Florida (license number SA8681) and her current practice location is 5314 Moss Oak Trl, Lake Park, Georgia. She can be reached at her office (for appointments etc.) via phone at (386) 362-8564.

NPI number for Mrs Kelly Green Jackson is 1083632467 and her current mailing address is 5314 Moss Oak Trl, Lake Park, Georgia. She does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1083632467.

Contact Information

Mrs Kelly Green Jackson, SLP
5314 Moss Oak Trl,
Lake Park, GA 31636-3300
(386) 362-8564
Not Available

Map and Direction




Healthcare Provider's Profile

Full NameMrs Kelly Green Jackson
GenderFemale
SpecialitySpeech-language Pathologist
Location5314 Moss Oak Trl, Lake Park, Georgia
Accepts Medicare AssignmentsDoes not participate in Medicare Program. She may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1083632467
  • Provider Enumeration Date: 07/17/2006
  • Last Update Date: 01/27/2025

Medical Identifiers

Medical identifiers for Mrs Kelly Green Jackson such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1083632467NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
235Z00000XSpeech-language Pathologist SA8681 (Florida)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. Mrs Kelly Green 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 AddressPractice Location Address
Mrs Kelly Green Jackson, SLP
5314 Moss Oak Trl,
Lake Park, GA 31636-3300

Ph: (386) 362-8564		Mrs Kelly Green Jackson, SLP
5314 Moss Oak Trl,
Lake Park, GA 31636-3300

Ph: (386) 362-8564

Reviews and Comments


Speech-Language Pathologist in Lake Park, GA


Speech-Language Pathologist
Medicare: Not Enrolled in Medicare
Practice Location: 6689 Lake Park Rd, Lake Park, GA 31636
Phone: 910-260-0969    
Nancy Heath,
Speech-Language Pathologist
Medicare: Not Enrolled in Medicare
Practice Location: 5701 Clydetta Dr, Lake Park, GA 31636
Phone: 478-278-6900    

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