DR. SHELLI SHULTZ JACKSON (NPI# 1033129010) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033129010 |
| Entity Type | Individual |
| Full Name | DR. SHELLI SHULTZ JACKSON |
| Credential | PH.D. |
| Practice Address |
2500 Boardwalk Ste 218 Norman OK 73069-6664 |
| Practice Telephone | 4053298501 |
| Practice Fax Number | 4052530581 |
| Mailing Telephone | 4053298501 |
| Mailing Fax Number | 4052530581 |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2018-04-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | 922 | OK | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | 100839280A | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326492026 | Shelli Jackson | Psychologist | 979 Woodland Pkwy Ste 101-48, San Marcos, CA 92069-2220 | 2016-04-19 |
| 1467798553 | Shelli M Jackson | Nurse Practitioner | 2602 Wilmington Rd Ste 200, New Castle, PA 16105-1538 | 2012-12-18 |
| Street Address |
2500 BOARDWALK STE 218 |
| City | NORMAN |
| State | OK |
| Zip Code | 73069-6664 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760847255 | Shelli S. Jackson, Phd, Pllc | Psychologist | 2500 Boardwalk Ste 218, Norman, OK 73069-6664 | 2015-12-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235739764 | Pinnacle Family Health Care | Family Medicine | 2781 Washington Drive, Suite 101, Norman, OK 73069 | 2020-10-26 |
| 1063030088 | Kristal Ladawn Vasquez | Nurse Practitioner | 4019 North Flood Ave, Normam, OK 73069 | 2020-07-07 |
| 1841828290 | Cheryl Renee Stoepker | Nurse Practitioner | 3441 24th Ave Nw, Norman, OK 73069 | 2020-03-31 |
| 1427689215 | Bodyworx Primary Care, LLC | Nurse Practitioner | 4019 N Flood Ave, Norman, OK 73069 | 2020-01-30 |
| 1528539376 | Monika Potdar | Pharmacist | 2550 Mount Williams Dr, Norman, OK 73069 | 2018-12-05 |
| 1861962193 | Bethany Spring Browne | Physician Assistant | 209 Hal Muldrow Dr, Apt 7, Norman, OK 73069 | 2018-11-29 |
| 1528536109 | Summit Health and Wellness Center LLC | Counselor | 2770 Washington Dr, Suite 100, Norman, OK 73069 | 2018-11-13 |
| 1386121960 | Sarah Lawhead | Case Manager/Care Coordinator | 525 Dakota St, Norman, OK 73069 | 2018-07-25 |
| 1528554433 | Katie Blankenship | Occupational Therapist | 330 W Grey Street 100-2, Norman, OK 73069 | 2018-07-03 |
| 1568918886 | Brandi Deerinwater | Case Manager/Care Coordinator | 321 S Peters, Norman, OK 73069 | 2016-08-28 |
| Find all providers in zip 73069 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| 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 procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174945984 | Ron L Cummings | Psychologist | 4505 Newport Dr, Norman, OK 73072-4359 | 2014-01-14 |
| 1023453586 | Avina Khiatani | Psychologist | 620 Elm Ave Ste 4011, Norman, OK 73069-8801 | 2013-05-09 |
| 1942551874 | Kathryn Ann Boyd | Psychologist | 545 S Lahoma Ave, Norman, OK 73069-5525 | 2012-10-02 |
| 1649509266 | Carmen Marie Tebbe | Psychologist | 1225 W Main St Ste 102, Norman, OK 73069-6851 | 2009-12-10 |
| 1871704288 | Melissa Lou Frey | Psychologist | 800 W Rock Creek Rd Ste 101, Norman, OK 73069-8581 | 2007-05-25 |
| 1871639583 | Gale Llewellyn Hobson | Psychologist | 916 Classen Blvd, Norman, OK 73071-5014 | 2007-01-29 |
| 1780740837 | Vicki J Perkins | Psychologist | 3401 180th Ave Se, Norman, OK 73026-9659 | 2006-12-30 |
| 1811003742 | Rhonda Laurene Tannehill | Psychologist | 2268 Highway 8 E, Norman, AR 71960-8508 | 2006-08-22 |
| 1740213545 | Sandra L Tedder | Psychologist | 4707 Willow Grove Dr, Norman, OK 73072 | 2006-07-08 |
| 1013955780 | Mary Jane Argentos | Psychologist | 1300 Mcgee Dr, Norman, OK 73072-5858 | 2006-06-03 |
| Find all providers in NORMAN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.