Type 2 · Organization ✓ Active NPI ✓ Valid NPI checksum

Janissa D Jackson Phd Pllc

Clinical Child & Adolescent Psychologist in Fayetteville, AR · enumerated 2008 · authorized official Lavonna Latta, Business Manager.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1871762476

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Registry record

Entity type Organization (Type 2)

Legal business name Janissa D Jackson Phd Pllc

Other name <Unavail>

Practice address 1 W Sunbridge Dr, Fayetteville, AR, 72703

Phone (479) 443-5575

Fax (479) 443-9554

Enumeration date Feb 27, 2008

Last updated in NPPES Feb 27, 2008

Taxonomy & classification

103TC0700X Clinical Psychologist Behavioral Health & Social Service Providers · License 07-01P (AR) Secondary

103TC2200X Clinical Child & Adolescent Psychologist Behavioral Health & Social Service Providers · License 07-01P (AR) Primary

Authorized official

Name Lavonna Latta

Title Business Manager

Phone (479) 443-5575

Other identifiers

Identifier	Type	State	Issuer
5A252	Other	AR	BLUECROSS BLUESHIELD

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

Where is Janissa D Jackson Phd Pllc located?

The practice location on file with NPPES is in Fayetteville, AR.

How current is this record?

Data comes from the CMS NPPES public dissemination file; this record was last updated in NPPES on 2008-02-27. Verify at npiregistry.cms.hhs.gov.

Providers at this address

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2008-02-27.