Provider Demographics
NPI:1013305499
Name:JENNIFER ACKRISH, PSY.D. LLC
Entity Type:Organization
Organization Name:JENNIFER ACKRISH, PSY.D. LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:ACKRISH
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:561-299-0483
Mailing Address - Street 1:11295 NW 71ST CT
Mailing Address - Street 2:
Mailing Address - City:PARKLAND
Mailing Address - State:FL
Mailing Address - Zip Code:33076-3851
Mailing Address - Country:US
Mailing Address - Phone:561-299-0483
Mailing Address - Fax:954-566-1186
Practice Address - Street 1:11295 NW 71ST CT
Practice Address - Street 2:
Practice Address - City:PARKLAND
Practice Address - State:FL
Practice Address - Zip Code:33076-3851
Practice Address - Country:US
Practice Address - Phone:561-299-0483
Practice Address - Fax:954-566-1186
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-07
Last Update Date:2021-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY9129103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty