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ROBERT LEON JACKSON PH.D.
NPI 1104032952
Psychologist - Clinical in Springfield, IL

Active since May 15, 2007
1201 S VETERANS PKWY, SUITE B, SPRINGFIELD, IL 62704(217) 793-2770 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Robert Leon Jackson Ph.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ROBERT LEON JACKSON PH.D. (NPI 1104032952) is an individual clinical provider in Springfield, Illinois and active in the NPI registry since May 2007.

NPPES Registry Identity

NPI1104032952
Entity TypeIndividualMale
Primary Taxonomy103TC0700X
Provider Legal NameROBERT LEON JACKSONCredential: PH.D.
Location Address1201 S VETERANS PKWY, SUITE BSpringfield, IL 62704-6321
Mailing Address16 Longbow LnSpringfield, IL 62704-5324 · (217) 787-3143
Phone(217) 793-2770
Sole ProprietorYes
Enumeration DateMay 15, 2007
Last NPPES UpdateJuly 8, 2007
✔ NPI 1104032952 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
Definition
A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.
1201 S VETERANS PKWY, Springfield, IL 62704
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Other Identifiers 1

Medicare ID-Type Unspecified202656IL

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

VIRGINIA K BAKER LCPC
Counselor (Professional)
1201 S VETERANS PKWY, SUITE B
SPRINGFIELD, IL 62704
Sangamon County (217) 793-2770
MARY LYNN OSSOWSKI LCSW
Social Worker (Clinical)
1201 S VETERANS PKWY, SUITE B
SPRINGFIELD, IL 62704
Sangamon County (217) 793-2770
SPRINGFIELD CTR PSYCHOLOGICAL SVS
Psychologist (Clinical)
1201 S VETERANS PKWY, SUITE B
SPRINGFIELD, IL 62704
Sangamon County (217) 793-2770
THERESA LYNN HANSEN LCSW
Social Worker (Clinical)
1201 S VETERANS PKWY, SUITE B
SPRINGFIELD, IL 62704
Sangamon County (217) 793-2770

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Robert Jackson's NPI number?

The NPI number for Robert Jackson is 1104032952. It was assigned to this individual provider in the NPPES registry on May 15, 2007.

Where is Robert Jackson located?

Robert Jackson practices at 1201 S Veterans Pkwy Suite B, Springfield, IL 62704. The listed phone number is (217) 793-2770.

What is Robert Jackson's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

When was this NPI record last updated?

The NPPES record for Robert Jackson was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.