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Active NPI 1992307870 Individual Practitioner Female Practitioner

Shantell Jackson

Psychologist - Intellectual & Developmental Disabilities • Wickliffe, OH

Professional Overview & Biography Verified Profile Summary

Shantell Jackson is a registered healthcare professional specializing in Psychologist - Intellectual & Developmental Disabilities in Wickliffe, OH. Practice services are available at 1834 ROBINDALE ST under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

1834 Robindale St

Wickliffe, OH 440921843

Telephone 3303682617
Associated Practice Facility / Clinic
🏢 Purity Home Health Care Llc Facility NPI 1124898630

Specialty Benchmarks & Practice Insights

Comparative analytics for Psychologist - Intellectual & Developmental Disabilities in Wickliffe, OH

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 44.0 Yrs
Regional Practice Density
1 Specialists

Practicing in Wickliffe, OH (91 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: 2020-11-15
Psychologist - Intellectual & Developmental Disabilities Primary Specialty

NUCC Taxonomy Code: 103TM1800X

State License OH 4303862

Definition to come...

Career & Practice History Timeline

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

6 Historical Events
✅
NPI Profile Active November 15, 2020

NPI status registered as active in NPPES database

📍
Updated Practice Location November 15, 2020

Registered at 1834 ROBINDALE ST, WICKLIFFE, OH 440921843 (Tel: 3303682617)

📍
Updated Business Mailing Address November 15, 2020

Registered at 1834 ROBINDALE ST, WICKLIFFE, OH 440921843 (Tel: 3303682617)

👤
Provider Name / Credentials Updated November 15, 2020

Recorded as SHANTELL JACKSON

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) November 15, 2020

Psychologist (License #4303862 in OH)

🟢
Initial NPI Registration & Enumeration November 15, 2020

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

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NPI Administrative Meta

NPI Number: 1992307870
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: November 15, 2020
Last Update: November 15, 2020
Sole Proprietor: No
Update or Correct Profile

Mailing Address

1834 Robindale St

Wickliffe, OH 440921843

Phone: 3303682617

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.