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C WESLEY JACKSON JR PHD INC
NPI 1720202500
Psychologist - Clinical in Cleveland Heights, OH

Active since April 12, 2007
2980 WASHINGTON BLVD, CLEVELAND HEIGHTS, OH 44118(216) 321-9355(216) 932-3341 Get Directions Write a Review

NPPES record last updated: July 30, 2012. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About C Wesley Jackson Jr Phd Inc NPPES

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

C WESLEY JACKSON JR PHD INC (NPI 1720202500) is a healthcare organization registered as a clinical in Cleveland Heights, Ohio and active in the NPI registry since April 2007. The organization lists C Wesley Jackson, President Owner, as its authorized official.

NPPES Registry Identity

NPI1720202500
Entity TypeOrganization
Primary Taxonomy103TC0700X
Legal Business NameC WESLEY JACKSON JR PHD INC
Location Address2980 WASHINGTON BLVDCleveland Heights, OH 44118-2450
Mailing Address2980 Washington BlvdCleveland Heights, OH 44118-2450 · (216) 321-9355 · Fax (216) 932-3341
Phone(216) 321-9355
Fax(216) 932-3341
Organization SubpartNo
Authorized OfficialC Wesley JacksonPresident Owner · (216) 321-9355
Enumeration DateApril 12, 2007
Last NPPES UpdateJuly 30, 2012
✔ NPI 1720202500 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
Licenses✔ Licensed in OH · 474✔ Licensed in MI · 000519
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.
2980 WASHINGTON BLVD, Cleveland Heights, OH 44118
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Other Identifiers 2

Medicaid0253309OH
Medicare ID-Type UnspecifiedCP09651

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

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 C Wesley Jackson Jr Phd Inc's NPI number?

The NPI number for C Wesley Jackson Jr Phd Inc is 1720202500. It was assigned to this organization in the NPPES registry on April 12, 2007.

Where is C Wesley Jackson Jr Phd Inc located?

C Wesley Jackson Jr Phd Inc is located at 2980 Washington Blvd, Cleveland Heights, OH 44118. The listed phone number is (216) 321-9355.

What is C Wesley Jackson Jr Phd Inc'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 C Wesley Jackson Jr Phd Inc was last updated on July 30, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.