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General NPI Number Information
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NPI Number | 1649054743
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Entity Type | Organization
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Legal Business Name | LAUREN I JACKSON, PHD, PLLC
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Dates
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Enumeration Date | 08/21/2023
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Last Update Date | 11/14/2025
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Provider Practice Location Address
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Address Line | 5555 ARAPAHO RD
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City | DALLAS
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State | TX
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Zip | 75248-3442
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Country | US
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Telephone | 972-661-1880
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Fax |
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Provider Business Mailing Address
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Address Line | 3005 HANOVER ST
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City | DALLAS
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State | TX
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Zip | 75225-7823
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Country | US
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Telephone | 214-794-8507
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Fax |
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | MRS. CHRISTINA PIERING
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Credential |
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Telephone | 469-236-1622
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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