CHERRON JACKSON (NPI# 1164880167) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164880167 |
| Entity Type | Individual |
| Full Name | CHERRON JACKSON |
| Practice Address |
55 Fishfry St Hartford CT 06120-1203 |
| Practice Telephone | 8602478300 |
| Enumeration Date | 2016-02-04 |
| Last Update Date | 2016-02-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers |
| Street Address |
55 FISHFRY ST |
| City | HARTFORD |
| State | CT |
| Zip Code | 06120-1203 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487637724 | Community Substance Abuse Centers Inc | Counselor | 55 Fishfry St, Hartford, CT 06120-1203 | 2005-11-21 |
| 1992317697 | Jeni Elizabeth Fletcher | Counselor | 55 Fishfry St, Hartford, CT 06120-1203 | 2020-08-24 |
| 1871114686 | Angela Lucke | Counselor | 55 Fishfry St, Hartford, CT 06120-1203 | 2020-05-04 |
| 1083244867 | Waldemar Malave Sr. | Counselor | 55 Fishfry St, Hartford, CT 06120-1203 | 2020-01-22 |
| 1326686841 | Stephany Hunt | Counselor | 55 Fishfry St, Hartford, CT 06120-1203 | 2019-12-16 |
| 1194366336 | Mirian I Laracuente | Counselor | 55 Fishfry St, Hartford, CT 06120-1203 | 2019-09-30 |
| 1649811886 | Phyllis Mischell Hansberry | Counselor | 55 Fishfry St, Hartford, CT 06120-1203 | 2019-09-30 |
| 1982251815 | Stephanie A Berry | Counselor | 55 Fishfry St, Hartford, CT 06120-1203 | 2019-08-26 |
| 1306300066 | Ranjeeta Nair | Counselor | 55 Fishfry St, Hartford, CT 06120-1203 | 2019-01-28 |
| 1366906026 | Sabrina Noel Bradford | Counselor | 55 Fishfry St, Hartford, CT 06120-1203 | 2019-01-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245664770 | Amy Rodriguez | Social Worker | 2550 Main Street, Hartford, CT 06120 | 2013-09-03 |
| 1144578741 | Community Substance Abuse Center | Case Management | 55 Fish Fry Street, Hartford, CT 06120 | 2012-08-29 |
| 1225394190 | Edward Billie | Case Management | 27 East St, Apt 2, Hartford, CT 06120 | 2012-04-05 |
| 1497065163 | Sharron Lee Laplante | General Practice | 177 Weston Street, Hartford, CT 06120 | 2010-10-15 |
| 1417135195 | Ling Li | Nurse Practitioner | 3580 Main Street, Hartford, CT 06120 | 2008-02-05 |
| 1750592564 | Avon Medical Pharmacy | Durable Medical Equipment & Medical Supplies | Arrow Prescription Center 11, 500 Albany Avenue, Hartford, CT 06120 | 2007-05-24 |
| 1609942416 | Gene David Kirschenbaum | Obstetrics & Gynecology | 360 Market Street, Hartford, CT 06120 | 2006-11-27 |
| 1740361179 | Pamela Bond Ponichtera | Nurse Practitioner | 500 Albany Avenue, Pediatric Clinic, Hartford, CT 06120 | 2006-10-19 |
| 1841301876 | Community Renewal Team, Inc. | Clinic/Center | 330 Market Street, Hartford, CT 06120 | 2006-08-31 |
| 1548803844 | Courtney Anne Barnes | Social Worker | 330 Market St, Hartford, CT 06120 | 2019-10-20 |
| Find all providers in zip 06120 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164064044 | Shawn Tyson | Counselor | 330 Main St Fl 1, Hartford, CT 06106-1851 | 2019-10-12 |
| 1114401510 | Roberto Carlos Vargas | Counselor | 926 Asylum Ave Apt 206, Hartford, CT 06105-2402 | 2018-09-20 |
| 1053859553 | Michael Heaven | Counselor | 601 Blue Hills Ave, Apt B2, Hartford, CT 06112-1254 | 2017-02-03 |
| 1043678063 | Daisy Baez | Counselor | 59 Nelson St, Hartford, CT 06120-2041 | 2016-02-04 |
| 1821495391 | Halcyon Clinical Services, LLC | Counselor | 75 Charter Oak Ave, Hartford, CT 06106-1903 | 2014-11-29 |
| 1346654399 | Edward Gonzalez | Counselor | 27 May Street 2nd Floor, Hartford, CT 06104 | 2014-06-18 |
| 1306100367 | Marco Neves | Counselor | 106 Standish St, Hartford, CT 06114-2936 | 2012-06-25 |
| 1275804874 | Ray T. Bishop | Counselor | 16 Weston St, Hartford, CT 06120-1504 | 2012-01-13 |
| 1144591710 | Philip Frederick Richmond | Counselor | 18 Weston St, Hartford, CT 06120-1504 | 2012-01-13 |
| 1871862789 | Latino Community Services, Inc. | Counselor | 221 Main St Fl 3, Hartford, CT 06106-1890 | 2011-12-21 |
| Find all providers in HARTFORD | ||||
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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.