# JACKSON PSYCHIATRIC SERVICES PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1174353486
- **Authorized official:** ELSIE DIEGUEZ-JACKSON (OWNER/CERTIFIED NP)
- **Authorized official phone:** (315) 289-6828

## Contact information

- **Practice address:** 1500 MAIN STREET, \#15024, SPRINGFIELD, MA 01115-5024
- **Practice address phone:** (413) 265-8714
- **Practice address fax:** (413) 225-8712
- **Mailing address:** PO BOX 15024, SPRINGFIELD, MA 01115-5024
- **Mailing address phone:** (413) 265-8714
- **Mailing address fax:** (413) 225-8712

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 08/02/2024
- **Last updated:** 12/24/2025