Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1902184732 Individual Practitioner Male Practitioner

Dr. Jared A Jackson , PhD

Psychologist • Fort Campbell, KY

Professional Overview & Biography Verified Profile Summary

Dr. Jared Jackson, PhD is a registered healthcare professional specializing in Psychologist in Fort Campbell, KY. Practice services are available at 6102 TENNESSEE AVE under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

6102 Tennessee Ave

Fort Campbell, KY 422235940

Telephone 9098107332
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Psychologist in Fort Campbell, KY

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 18.9 Yrs
Regional Practice Density
11 Specialists

Practicing in Fort Campbell, KY (567 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2025-04-28
Psychologist Primary Specialty

NUCC Taxonomy Code: 103T00000X

State License AL 1690

A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

6 Associated Practitioners
Karin Mendoza , MSN, RN

Registered Nurse - Psychiatric/Mental Health

NPI 1003671868

Master of Science in Nursing, Registered Nurse

Laura O'donnell , RN, CMGT-BC

Registered Nurse - Case Management

NPI 1356108054

Registered Nurse, CMGTBC

Wesley Eberlin , PT

Physical Therapist

NPI 1538173877

Physical Therapist

John Boesch , RD

Dietitian, Registered

NPI 1568929925

Registered Dietitian

Steven Miller , MS, ATC, CSCS

Specialist/Technologist - Athletic Trainer

NPI 1629950571

Master of Science, Certified Athletic Trainer, Certified Strength and Conditioning Specialist

Amanda Diemer

Registered Nurse - Case Management

NPI 1962193102

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

8 Historical Events
📍
Updated Practice Location May 08, 2025

Registered at 6102 TENNESSEE AVE, FORT CAMPBELL, KY 422235940 (Tel: 9098107332)

📍
Updated Business Mailing Address May 08, 2025

Registered at BLDG 6102 TENNESSEE, FORT CAMPBELL, KY 42223 (Tel: 9098107332)

NPI Profile Active August 08, 2016

NPI status registered as active in NPPES database

📍
Updated Practice Location August 08, 2016

Registered at 68-121 AU ST, 306, WAIALUA, HI 967919453 (Tel: 9098107332)

📍
Updated Business Mailing Address August 08, 2016

Registered at 68-121 AU ST, 306, WAIALUA, HI 967919453 (Tel: 9098107332)

👤
Provider Name / Credentials Updated August 08, 2016

Recorded as JARED JACKSON, PH.D.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) August 08, 2016

Psychologist (License #1690 in AL)

🟢
Initial NPI Registration & Enumeration July 27, 2011

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

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NPI Administrative Meta

NPI Number: 1902184732
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 27, 2011
Last Update: May 08, 2025
Sole Proprietor: Yes

Mailing Address

Bldg 6102 Tennessee

Fort Campbell, KY 42223

Phone: 9098107332

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.