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

Wallace J Jackmon, PHD

Individual provider Clinical Psychologist · NPI 1427020957

Wallace J Jackmon, PHD is a Clinical Social Worker in Sioux Falls, South Dakota. Qualified in 2007, 19 years ago. Accepts Medicare assignment. Licensed in South Dakota.

Years since qualifying
19
Licensed in
SD
In the registry since
2006
What do these letters mean?
PHD — Doctor of Philosophy
A research doctorate. In healthcare it usually sits alongside a clinical licence.

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Practice location Address checks out

4400 W 69th St Ste 1500
Sioux Falls, SD 57108-8170
Phone: (605) 322-5700
Fax: (605) 322-5704
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Psychologist (primary) Taxonomy 103TC0700X · Licence 477 (SD)

Record details

NPI number1427020957
Entity typeIndividual (Type 1)
GenderMale
Credentials PHD
Sole proprietorNo
NPI enumeratedFebruary 7, 2006
Last updated in NPPESOctober 11, 2018

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2007 (19 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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