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DR. LISA JACKSON PH.D.
NPI 1811012669
Psychologist - Cognitive & Behavioral in Clifton Park, NY

Active since March 20, 2007PECOS EnrolledAccepts Medicare Assignment
990 ROUTE 146, CLIFTON PARK, NY 12065(518) 581-9525 Get Directions Write a Review

NPPES record last updated: January 7, 2014. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Dr. Lisa Jackson Ph.d. NPPES

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

DR. LISA JACKSON PH.D. (NPI 1811012669) is an individual cognitive & behavioral provider in Clifton Park, New York, licensed in New York (016988) and active in the NPI registry since March 2007. She is enrolled in Medicare PECOS and is a graduate of Tulane University School Of Medicine (2001).

NPPES Registry Identity

NPI1811012669
Entity TypeIndividualFemale
Primary Taxonomy103TB0200X
Provider Legal NameDR. LISA JACKSONCredential: PH.D.
Location Address990 ROUTE 146Clifton Park, NY 12065-3617
Mailing Address990 Route 146Clifton Park, NY 12065-3617 · (518) 265-5264
Phone(518) 581-9525
Sole ProprietorYes
Medical School CMSTulane University School Of MedicineGraduated 2001
Enumeration DateMarch 20, 2007
Last NPPES UpdateJanuary 7, 2014
✔ NPI 1811012669 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychologist · Cognitive & BehavioralBehavioral Health & Social Service Providers
Taxonomy Code103TB0200X
License✔ Licensed in NY · 016988
Definition

A psychologist who reflects an experimental-clinical approach distinguished by use of principles of human learning and development and theories of cognitive processing to promote meaningful change in maladaptive human behavior and thinking.

Also ListedPsychologistTaxonomy 103T00000X · License 016988 (NY)
990 ROUTE 146, Clifton Park, NY 12065
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Lisa Jackson Ph.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9032201066
PECOS Enrollment IDI20070822001260
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 3

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

DR. ALICIA MICHELE SPARANO D.C.
Chiropractor
990 ROUTE 146
CLIFTON PARK, NY 12065
Saratoga County (518) 371-2176
DR. CHRISTOPHER FRANCIS SPARANO D.C.
Chiropractor
990 ROUTE 146
CLIFTON PARK, NY 12065
Saratoga County (518) 371-2176
SPARANO CHIROPRACTIC ASSOCIATES
Chiropractor
990 ROUTE 146
CLIFTON PARK, NY 12065
Saratoga County (518) 371-2176

Frequently Asked Questions

What is Lisa Jackson's NPI number?

The NPI number assigned to this healthcare provider is 1811012669, enumerated as an "individual" on March 20, 2007.

Where is the provider located?

The provider is located at 990 ROUTE 146 CLIFTON PARK, NY 12065 and the phone number is (518) 581-9525.

What is the provider's specialty?

Psychologist with taxonomy code 103TB0200X and a focus in Cognitive & Behavioral.