DR. LISA ANN JACKSON (NPI# 1316071749) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1316071749 |
Entity Type | Individual |
Full Name | DR. LISA ANN JACKSON |
Credential | PHD |
Practice Address |
4955 N Bailey Ave Amherst NY 14226-1206 |
Mailing Address |
332 Dan Troy Dr Williamsville NY 14221-3514 |
Practice Telephone | 7168330292 |
Practice Fax Number | 7168330215 |
Mailing Telephone | 7168394658 |
Enumeration Date | 2007-03-15 |
Last Update Date | 2007-07-08 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 103G00000X | Clinical Neuropsychologist | 011968 | NY | Behavioral Health & Social Service Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
NY | 01474937 | 05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1598300329 | Lisa Ann Jackson | Speech-Language Pathologist | 802 S Yucatan Dr, Tucson, AZ 85710-4933 | 2019-11-15 |
1194292441 | Lisa Jackson | Nurse's Aide | 2423 Montana Blue Dr, Spring, TX 77373-7871 | 2018-10-25 |
1770027781 | Lisa Jackson | Registered Nurse | 1520 E Calhoun St, Anderson, SC 29621-2210 | 2016-12-09 |
1154711166 | Lisa Jackson | Psychologist | 20111 Horace Harding Expy, Oakland Gardens, NY 11364-1639 | 2015-01-28 |
1720493224 | Lisa Nicole Jackson | Specialist/Technologist | 3200 Troup Hwy Ste, 120, Tyler, TX 75701 | 2014-06-24 |
1831468420 | Lisa Nicole Jackson | Licensed Practical Nurse | 1599 Prospect Pl Apt 1e, Brooklyn, NY 11233-4451 | 2011-12-28 |
1992023030 | Lisa Jackson | Massage Therapist | 7200 Sw 8th Ave Apt 9, Gainesville, FL 32607-1883 | 2010-05-13 |
1487844973 | Lisa Nicole Jackson | Obstetrics & Gynecology | 89-06 135th St, Room 6a, Jamaica, NY 11418 | 2007-07-31 |
1497828826 | Lisa Lanette Jackson | Nurse Practitioner | 1117 Chestnut St, Lewisville, AR 71845 | 2006-11-15 |
1972696516 | Lisa Thompson Jackson | Nurse Anesthetist, Certified Registered | 1500 E. Woodrow Wilson, Jackson, MS 39216 | 2006-10-02 |
Street Address |
4955 N BAILEY AVE |
City | AMHERST |
State | NY |
Zip Code | 14226-1206 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1134114143 | Howard C Wilinsky | Psychiatry & Neurology | 4955 N Bailey Ave, Ste 130, Amherst, NY 14226-1206 | 2005-09-15 |
1245675669 | Paul R. Young Md Pllc | Otolaryngology | 4955 N Bailey Ave, Suite 202, Amherst, NY 14226-1206 | 2013-04-30 |
1710289772 | Jean Marie Gargala | Social Worker | 4955 N Bailey Ave, Suite 214, Amherst, NY 14226-1206 | 2010-11-24 |
1922313113 | Joshna Singh | Psychiatry & Neurology | 4955 N Bailey Ave, Suite No 130, Amherst, NY 14226-1206 | 2010-08-11 |
1184858458 | Paul Raymond Young | Otolaryngology | 4955 N Bailey Ave, Suite 202, Amherst, NY 14226-1206 | 2009-05-14 |
1376784306 | Amherst General Endoscopy Center LLC | Clinic/Center | 4955 N Bailey Ave, Suite 207, Amherst, NY 14226-1206 | 2009-03-21 |
1619150380 | Howard C. Wilinsky, M.d., P.C. | Psychiatry & Neurology | 4955 N Bailey Ave, Ste 130, Amherst, NY 14226-1206 | 2007-12-17 |
1013043140 | Anthony M. Avellanosa | Neurological Surgery | 4955 N Bailey Ave, Suite 201, Amherst, NY 14226-1206 | 2007-02-25 |
1013056829 | Pamela Ann Myers | Social Worker | 4955 N Bailey Ave, Suite 130, Amherst, NY 14226-1206 | 2007-02-06 |
1285716597 | John E. Northman | Psychologist | 4955 N Bailey Ave, Suite 204, Amherst, NY 14226-1206 | 2006-10-19 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1578175089 | Rafael Khavis | Dentist | Dent Tower Suite 401, 3980 Sheridan Drive, Amherst, NY 14226 | 2020-08-18 |
1942846209 | Anthony Constance | Occupational Therapist | Excelsior Orthopaedics, 3925 Sheridan Drive, Amherst, NY 14226 | 2019-11-21 |
1730743931 | Mark Marcello | Physical Therapy Assistant | 4498 Main/harlem Rd Suite 24, Amherst, NY 14226 | 2019-04-24 |
1528531084 | Kimberly Girdlestone | Social Worker | 3960 Harlem Road, Suite 6b, Buffalo, NY 14226 | 2019-01-08 |
1043781503 | Justin Patrick Nelson | Physical Therapist | 4498 Main St. Suite 24, Amherst, NY 14226 | 2018-12-10 |
1962979195 | Meghan Jim Dougher | Student in an Organized Health Care Education/Training Program | 167 Darwin Dr., Snyder, NY 14226 | 2018-10-25 |
1790260982 | Orchard Park Dentalcare Pllc | Clinic/Center | 3302 Sheridan Dr, Buffalo, NY 14226 | 2018-10-03 |
1619472719 | Rapha Family Medical Wellness PC | Family Medicine | 3610 Main Street, Amherst, NY 14226 | 2018-03-29 |
1790299832 | Medical Ecp of Western New York P C | Internal Medicine | 4330 Maple Rd Ste 102, Amherst, NY 14226 | 2017-11-28 |
1841709425 | Elisabeth Wagner | Physical Therapy Assistant | 4498 Main St., Suite 24, Amherst, NY 14226 | 2017-09-26 |
Find all providers in zip 14226 |
Taxonomy Code | 103G00000X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Clinical Neuropsychologist |
An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |
Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1528245859 | Thomas C. Garbett | Clinical Neuropsychologist | 14 Hickory Ln, Amherst, MA 01002-2845 | 2008-01-29 |
1215994207 | Bradley John Crenshaw | Clinical Neuropsychologist | 79 S Pleasant St, Suite 6, Amherst, MA 01002-2370 | 2006-04-26 |
1558493148 | Patricia Anne Schumm | Clinical Neuropsychologist | 48 N Pleasant St, 207, Amherst, MA 01002-1738 | 2007-03-10 |
1497850911 | Dent Neurologic Group LLP | Clinical Neuropsychologist | 3980 Sheridan Dr, Suite 200, Amherst, NY 14226-1727 | 2006-09-13 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1609408046 | Nassau Neuropsychological Services, Pllc | Clinical Neuropsychologist | 386 S Oyster Bay Rd, Hicksville, NY 11801-3509 | 2020-02-04 |
1922656875 | Kouros Emami | Clinical Neuropsychologist | 525 East 71st St., 5th Floor, New York, NY 10021 | 2019-09-03 |
1720633860 | Emily Kurlansik | Clinical Neuropsychologist | 300 W 55th St Apt 6c, New York, NY 10019-5164 | 2019-08-06 |
1174181382 | Kayla Whearty | Clinical Neuropsychologist | 1554 Northern Blvd Ste 204, Manhasset, NY 11030-3054 | 2019-06-03 |
1447729595 | Beth Krone | Clinical Neuropsychologist | 6818 Bay Cliff Ter, Brooklyn, NY 11220-5114 | 2018-11-19 |
1750860144 | Linda Cristina Calderon | Clinical Neuropsychologist | 635 W 165th St Rm 633a, New York, NY 10032-3724 | 2018-08-07 |
1366936585 | Nicole Feirsen | Clinical Neuropsychologist | 3307 Bainbridge Ave Fl 1, Bronx, NY 10467-2850 | 2018-06-20 |
1306349493 | Abhishek Jaywant | Clinical Neuropsychologist | 525 E 68th St # F-1699g, New York, NY 10065-4870 | 2018-03-14 |
1043718505 | Elsa Lee | Clinical Neuropsychologist | 25418 Northern Blvd Ste 3, Little Neck, NY 11362-1451 | 2018-01-30 |
1154829000 | Alice Brown Brandwein | Clinical Neuropsychologist | 445 Park Ave Fl 2, New York, NY 10022-8649 | 2018-01-25 |
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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.