Kelly-Jackson, Lynisha

Kelly-Jackson, Lynisha is an sole proprietor health care provider with primary practice located at 992 Montgomery Ln , Polk City FL 33868-9097. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / School, Behavioral Health & Social Service Providers / Psychologist. Behavioral Health & Social Service Providers / Psychologist is her primary health care specialty. Kelly-Jackson, Lynisha can be contacted via phone (813) 638-5836.

Contact Information

Primary practice address
992 Montgomery Ln Polk City FL 33868-9097
Phone: (813) 638-5836
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / School 103TS0200X 70907 Texas
Behavioral Health & Social Service Providers / Psychologist 103T00000X 38090 Texas

Profile Details

NPI number 1891491296
LBN Legal business name Kelly-Jackson, Lynisha
Credentials PH.D, LP, LSSP, NCS
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 7th, 2023
Last updated Feb 7th, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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