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SHANTELL JACKSON
NPI 1992307870
Psychologist - Intellectual and Developmental Disabilities in Wickliffe, OH

Active since November 15, 2020
1834 ROBINDALE ST, WICKLIFFE, OH 44092(330) 368-2617 Get Directions Write a Review

NPPES record last updated: November 15, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Shantell Jackson NPPES

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

SHANTELL JACKSON (NPI 1992307870) is an individual intellectual and developmental disabilities provider in Wickliffe, Ohio, licensed in Ohio (4303862) and active in the NPI registry since November 2020.

NPPES Registry Identity

NPI1992307870
Entity TypeIndividualFemale
Primary Taxonomy103TM1800X
Provider Legal NameSHANTELL JACKSON
Location Address1834 ROBINDALE STWickliffe, OH 44092-1843
Mailing Address1834 Robindale StWickliffe, OH 44092-1843 · (330) 368-2617
Phone(330) 368-2617
Sole ProprietorNo
Enumeration DateNovember 15, 2020
NPPES CertifiedNovember 15, 2020
✔ NPI 1992307870 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · Intellectual and Developmental DisabilitiesBehavioral Health & Social Service Providers
Taxonomy Code103TM1800X
License✔ Licensed in OH · 4303862
1834 ROBINDALE ST, Wickliffe, OH 44092
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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 Shantell Jackson's NPI number?

The NPI number for Shantell Jackson is 1992307870. It was assigned to this individual provider in the NPPES registry on November 15, 2020.

Where is Shantell Jackson located?

Shantell Jackson practices at 1834 Robindale St, Wickliffe, OH 44092. The listed phone number is (330) 368-2617.

What is Shantell Jackson's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Intellectual and Developmental Disabilities, with taxonomy code 103TM1800X.

When was this NPI record last updated?

The NPPES record for Shantell Jackson was last updated on November 15, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.