MR. MARTIN JACKSON SR. (NPI# 1023319985) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023319985 |
| Entity Type | Individual |
| Full Name | MR. MARTIN JACKSON SR. |
| Credential | MED., LADC |
| Practice Address |
3 Barnard Ln Suite 112 Bloomfield CT 06002-2452 |
| Mailing Address |
Po Box 467 Middletown CT 06457-0467 |
| Practice Telephone | 8605595759 |
| Practice Fax Number | 8605595759 |
| Mailing Telephone | 8605595759 |
| Mailing Fax Number | 8605595759 |
| Enumeration Date | 2010-11-09 |
| Last Update Date | 2010-11-09 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
000158 | CT | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730114430 | Martin Norman Jackson | Podiatrist | 17309 Stedman Cir, Dallas, TX 75252-5741 | 2006-07-11 |
| Street Address |
3 BARNARD LN SUITE 112 |
| City | BLOOMFIELD |
| State | CT |
| Zip Code | 06002-2452 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376776682 | Lauren Olivia Gibson-carter | Social Worker | 3 Barnard Ln, Suite 107, Bloomfield, CT 06002-2452 | 2009-09-02 |
| 1811499106 | Lanita Carter | Counselor | 3 Barnard Ln, Bloomfield, CT 06002-2452 | 2018-03-02 |
| 1164943478 | Kelley Anne Whittaker | Counselor | 3 Barnard Ln, Bloomfield, CT 06002-2452 | 2017-06-28 |
| 1730563016 | A Tree of Life Counseling Center LLC | Social Worker | 3 Barnard Ln, 3rd Floor, Bloomfield, CT 06002-2452 | 2015-07-16 |
| 1083095988 | Psychotherapy Healing Services, LLC | Social Worker | 3 Barnard Ln, Suite 310, Bloomfield, CT 06002-2452 | 2015-06-16 |
| 1861803421 | Lynn Mahoney | Marriage & Family Therapist | 3 Barnard Ln, Suite 110, Bloomfield, CT 06002-2452 | 2014-05-16 |
| 1609296904 | Carpe Diem Counseling LLC | Clinic/Center | 3 Barnard Ln, Suite 110, Bloomfield, CT 06002-2452 | 2014-04-24 |
| 1053735878 | Toolsforsuccesscounseling LLC | Counselor | 3 Barnard Ln, Suite 303a, Bloomfield, CT 06002-2452 | 2014-02-13 |
| 1205109915 | Sign of The Flying Turtle LLC | Counselor | 3 Barnard Ln, Suite 302, Bloomfield, CT 06002-2452 | 2012-02-13 |
| 1578854154 | Marva Beckford Lcsw, LLC | Social Worker | 3 Barnard Ln, Office 312, Bloomfield, CT 06002-2452 | 2011-04-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558908897 | Duncaster, Inc. | Clinic/Center | 30 Loeffler Rd., Bloomfield, CT 06002 | 2019-12-05 |
| 1104467919 | Caroline Suzanne Carey Oesch | Counselor | 71 West Dudley St, Bloomfield, CT 06002 | 2019-10-02 |
| 1679047534 | Inspire Me, LLC | Counselor | 1-2 Camelot Drive, Bloomfield, CT 06002 | 2019-01-14 |
| 1508348947 | Rebecca Perry | Student in an Organized Health Care Education/Training Program | 693 Bloomfield Avenue, Bloomfield, CT 06002 | 2018-09-01 |
| 1760996946 | Monique Edwards | Social Worker | 705 New Briatin Ave, Chd, Bloomfield, CT 06002 | 2017-11-27 |
| 1225564412 | Merva E Dixon | Nurse Practitioner | 38 Hill Farm Rd, Bloomfield, CT 06002 | 2017-05-07 |
| 1538602610 | Jaime Acevedo | Counselor | 571 Bloomfield Ave, Bloomfield, CT 06002 | 2016-11-22 |
| 1669835138 | Jacob Badura | Pharmacist | 799-824 Park Ave, Bloomfield, CT 06002 | 2016-04-01 |
| 1316283328 | Julie Jason Farrelly | Counselor | 45 Wintonbury Ave Ste 102, Bloomfield, CT 06002 | 2012-12-19 |
| 1184915860 | Rachel Benedetto Scott | Surgery | 6 Northwestern Drive, Suite 305, Bloomfield, CT 06002 | 2011-04-28 |
| Find all providers in zip 06002 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235768664 | Jeff Chervenak | Counselor | 29 Juniper Rd, Bloomfield, CT 06002-2128 | 2020-04-07 |
| 1679047534 | Inspire Me, LLC | Counselor | 1-2 Camelot Drive, Bloomfield, CT 06002 | 2019-01-14 |
| 1497251623 | A Journey To- Wholeness, LLC | Counselor | 3 Barnard Ln Ste 306, Bloomfield, CT 06002-2495 | 2018-04-05 |
| 1760993224 | Vivian Arroyo | Counselor | 76 Baldwin Pl, Bloomfield, NJ 07003 | 2017-10-23 |
| 1194028365 | Gregory M. Koufacos | Counselor | 32 Rector Pl, Bloomfield, NJ 07003-4031 | 2010-12-10 |
| 1992017974 | Clarissa Lynette Garnett | Counselor | 4 Mayfair Ct, Bloomfield, CT 06002-3912 | 2010-07-07 |
| 1750571931 | Robin Denise Osborn | Counselor | 206 S Prairie Street, Bloomfield, MO 63825 | 2007-07-25 |
| 1215001318 | Carol Jennett | Counselor | 170 Washington St, 5c, Bloomfield, NJ 07003-2477 | 2006-11-20 |
| 1205109915 | Sign of The Flying Turtle LLC | Counselor | 3 Barnard Ln, Suite 302, Bloomfield, CT 06002-2452 | 2012-02-13 |
| 1295984599 | Milburn Cozort | Counselor | 206 S Prairie Street, Bloomfield, MO 63825 | 2008-09-11 |
| Find all providers in BLOOMFIELD | ||||
| City | BLOOMFIELD |
| Zip Code | 06002 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.