DR. LESLIE CECILIA JACKSON (NPI# 1952587271) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952587271 |
| Entity Type | Individual |
| Full Name | DR. LESLIE CECILIA JACKSON |
| Credential | PH.D. |
| Practice Address |
734 Kenilworth Cir Stone Mountain GA 30083-3416 |
| Practice Telephone | 4043178663 |
| Practice Fax Number | 4045084179 |
| Mailing Telephone | 4043178663 |
| Mailing Fax Number | 4045084179 |
| Enumeration Date | 2008-01-16 |
| Last Update Date | 2008-01-16 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
PSY002313 | GA | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750851325 | Leslie Jackson | Nurse Practitioner | 7106 Spencer Highway, Pasadena, TX 77505 | 2018-11-27 |
| 1780076745 | Leslie Jackson | Chore Provider | 18350 Lahser Rd, Detroit, MI 48219-4326 | 2015-02-28 |
| 1649320904 | Leslie K Jackson | Family Medicine | 404 E Main Cross St, Taylorville, IL 62568-2656 | 2007-01-11 |
| 1578171039 | Leslie D'layne Jackson | Social Worker | 43 N Cleveland St, Memphis, TN 38104-2301 | 2020-07-20 |
| 1497398218 | Leslie Denise Jackson | Advanced Practice Midwife | 1001 W Randol Mill Rd, Arlington, TX 76012-2513 | 2019-10-24 |
| 1699261826 | Leslie Aaron Jackson | Chiropractor | 7125 Marvin D Love Fwy Ste 107, Dallas, TX 75237-3111 | 2018-07-11 |
| 1669900239 | Leslie J Jackson | Social Worker | 650 Fulton St, Brooklyn, NY 11217-1517 | 2017-05-26 |
| 1083057152 | Leslie Schaad Jackson | Nurse Practitioner | 10515 Bells Ferry Rd Ste 200, Canton, GA 30114-4204 | 2013-04-09 |
| 1861753048 | Leslie L Jackson | Occupational Therapist | 9501 S King Dr, Dh 132, Chicago, IL 60628-1501 | 2012-06-04 |
| 1639379530 | Leslie Jackson | Case Manager/Care Coordinator | 2689 Sierra Hwy, Rosamond, CA 93560-6053 | 2007-07-19 |
| Street Address |
734 KENILWORTH CIR |
| City | STONE MOUNTAIN |
| State | GA |
| Zip Code | 30083-3416 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558830919 | Patriot Healthcare of Georgia, LLC | Family Medicine | 833 Hairston Road, Stone Mountain, GA 30083 | 2018-11-15 |
| 1710403431 | Trans Med Ems,llc | Ambulance | 4683 Redan Rd, Stone Mountain, GA 30083 | 2017-08-15 |
| 1447770482 | Dispatched Angels Home Care | In Home Supportive Care | 619 El Prado Court, Stone Mountain, GA 30083 | 2017-06-21 |
| 1396191086 | Suzanne Carter | Chore Provider | 1036 Allgood Rd, Stone Mountain, GA 30083 | 2016-05-11 |
| 1437520087 | Meaza Dada | Pharmacist | 1043 Thornwoode Lane, Stone Mountain, GA 30083 | 2015-10-08 |
| 1427436500 | Raeanne Elizabeth Gialanella | Occupational Therapist | 5839 Memorial Drive, Stone Mountain, GA 30083 | 2015-05-11 |
| 1265829824 | Latore Williams | Licensed Practical Nurse | 5300 Ridge Forest Drive, Stone Mountain, GA 30083 | 2015-04-22 |
| 1144625922 | Granville Theodore Freeman IIi | Counselor | 5000 Brittany Drive, Stone Mountain, GA 30083 | 2014-10-23 |
| 1588974208 | Terri R Collins | Counselor | 1020 Strap Hinge Trail, Stone Mountain, GA 30083 | 2010-10-15 |
| 1104064815 | Vistas Medical Center,pc | Clinic/Center | 5329 Memorial Dr Ste A, Stone Mountain, GEORGIA 30083 | 2009-02-03 |
| Find all providers in zip 30083 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407074610 | Kerry-ann Yolande Anderson | Psychologist | 2388 Rockbridge Rd, Stone Mountain, GA 30087-3607 | 2007-04-23 |
| 1144383142 | Sonya Burgess Rowland | Psychologist | 1012 N. Main Street, Stone Mountain, GA 30083-2944 | 2006-12-19 |
| 1194763516 | Lolita Michelle Rhone | Psychologist | 5954 Magnolia Rdg, Stone Mountain, GA 30087-6064 | 2006-06-04 |
| 1649681545 | Rashida W Brown | Psychologist | 913 Main St, Ste H, Stone Mountain, GA 30083-3096 | 2014-05-13 |
| 1528185725 | Carolyn Dunbar | Psychologist | 1324 Rockbridge Rd, Stone Mountain, GA 30087-3138 | 2007-03-23 |
| 1639235799 | Gwendolyn J Childs | Psychologist | 1012 Main St, Stone Mountain, GA 30083-2944 | 2006-12-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902403462 | Molly Elizabeth Katherine Mclaren | Psychologist | 1441 Clifton Rd Ne Ste 170, Atlanta, GA 30322-1004 | 2020-10-07 |
| 1588261945 | Raven Evans | Psychologist | 1800 Lake Park Dr Se Ste 123, Smyrna, GA 30080-7639 | 2020-10-07 |
| 1255945572 | Kerri Eileen Woodward | Psychologist | 6000 Lake Forrest Dr Ste 103, Atlanta, GA 30328-5902 | 2020-09-03 |
| 1932721784 | Essential Counseling & Consulting, Inc | Psychologist | 2800 Old Spanish Trl, College Park, GA 30349-4266 | 2020-05-15 |
| 1689296980 | Natalie N Watson-singleton | Psychologist | 2124 Cheshire Bridge Rd Ne Apt 4112, Atlanta, GA 30324-5733 | 2020-05-11 |
| 1336760164 | Lauren Olivia Patterson | Psychologist | 209 Thornwood Ct, Statesboro, GA 30458-0296 | 2020-05-04 |
| 1972123883 | Elizabeth Newton, Psyd and Assoc Inc | Psychologist | 1827 Powers Ferry Rd, Bldg 21, Atlanta, GA 30339 | 2020-04-21 |
| 1669091989 | Juliet Anne Buchwalter | Psychologist | 49 Lenox Pointe Ne Ste A, Atlanta, GA 30324-7426 | 2020-04-16 |
| 1790319549 | Thaddeus Reecesiri Reece | Psychologist | 771 Tulip Poplar Way, Lawrenceville, GA 30044-8819 | 2020-03-02 |
| 1508498395 | Walker Consulting & Psychological Services | Psychologist | 4375 Cobb Pkwy Se Ste 121, Atlanta, GA 30339-5537 | 2020-02-10 |
| Find all providers with the same taxonomy | ||||
| City | STONE MOUNTAIN |
| Zip Code | 30083 |
Please comment or provide details below to improve the information on DR. LESLIE CECILIA JACKSON.
| 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.