Joann Michelle Jackson in Goshen - Psychologist
Joann Michelle Jackson - NPI 1194739904
Joann Michelle Jackson is a Psychologist in Goshen, Indiana. Joann Michelle Jackson practices all healthcare services and medical treatments related to Psychologist. The NPI Number for Joann Michelle Jackson is 1194739904. The last update date is 2010-09-27.
Joann Michelle Jackson's current location address is 330 Lakeview Dr, Goshen, Indiana. You can contact this provider via phone number 5745331234 and fax number 5745372652. The mailing address for Joann Michelle Jackson is 330 Lakeview Dr, Goshen, Indiana. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Joann Michelle Jackson |
|---|---|
| Address | 330 Lakeview Dr, Goshen, Indiana |
| Phone Number | 5745331234 |
| Fax Number | 5745372652 |
| Sole Proprietor | N |
| Credentials | PSY.D. |
NPI Number Detail
| NPI Number | 1194739904 |
|---|---|
| Provider Enumeration Date | 2006-07-28 |
| Last Updated Date | 2010-09-27 |
Provider Mailing Address Detail
| Address | 330 Lakeview Dr |
|---|---|
| City | Goshen |
| State | Indiana (IN) |
| Post Code | 465289365 |
| Phone Number | 5745331234 |
| Fax Number | 5745372652 |
Provider's Primary Taxonomy Detail
| Speciality | Psychologist |
|---|---|
| Taxonomy | 103T00000X |
| Licence No | 20040982A |
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Definition: A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and proce |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 200200700A | IN | -- |
Post Comment/ Review Below
What is the unique identifier code issued to Joann Michelle Jackson by the Centers for Medicare & Medicaid Services (CMS)?
The Joann Michelle Jackson has been assigned the NPI (National Provider Identifier) 1194739904. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Could you kindly provide the complete physical address where Joann Michelle Jackson's facilities are geographically located?
The facilities of Joann Michelle Jackson are physically situated at the following location: 330 Lakeview Dr, Goshen, IN, 465289365.
What is Joann Michelle Jackson's area of expertise and its corresponding taxonomy classification?
The Joann Michelle Jackson's field of specialization is Psychologist, and it falls under the taxonomy code 103T00000X, which categorizes healthcare providers based on their areas of practice.
On what date did the Joann Michelle Jackson receive its 1194739904 assignment from the Centers for Medicare & Medicaid Services?
The Joann Michelle Jackson was assigned its 1194739904 by the Centers for Medicare & Medicaid Services on 2006-07-28.
When was the information pertaining to Joann Michelle Jackson most recently updated or revised?
The details related to Joann Michelle Jackson, including its address, specialty, and other relevant information, were last updated or revised on 2010-09-27.