Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Samuel Eli Jackson

Individual provider Behavior Technician · NPI 1376151266

Samuel Eli Jackson is a Behavior Technician in Columbus, Georgia. Licensed in Georgia. Registered with an NPI since 2020.

Licensed in
GA
In the registry since
2020
Specialties on file
2

Practice location Address checks out

1110 13th St Ste D
Columbus, GA 31901-2246
Phone: (706) 780-1704
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Behavior Analyst (primary) Taxonomy 103K00000X · Licence 12369125 (GA)
Behavior Technician Taxonomy 106S00000X

Record details

NPI number1376151266
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJuly 16, 2020
Last updated in NPPESOctober 25, 2023
Certification dateOctober 25, 2023
Mailing address1110 13th St Ste D, Columbus, GA 31901-2246

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