DR. MARIANNE JACKSON (NPI# 1184832396) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184832396 |
| Entity Type | Individual |
| Full Name | DR. MARIANNE JACKSON |
| Credential | PH.D. |
| Practice Address |
60 Plaza St E Apt 1k Brooklyn NY 11238-5033 |
| Practice Telephone | 7188574610 |
| Practice Fax Number | 7188573160 |
| Mailing Telephone | 7188574610 |
| Mailing Fax Number | 7188573160 |
| Enumeration Date | 2007-05-19 |
| Last Update Date | 2007-07-09 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
07305-1 | NY | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | VALUE OPTIONS MEMBER ID | 145969 | 01 |
| NY | 00953168 | 05 | |
| NY | CAQH PROVIDER ID | 11559263 | 01 |
| NY | VALUE OPTIONS VENDER ID | A123282 | 01 |
| NY | AETNA PROVIDER PIN | 5024687 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013386374 | Marianne Jackson | Registered Nurse | 1613 Stonefield St, Las Vegas, NV 89144-5405 | 2015-09-16 |
| 1841623790 | Marianne Louise Jackson | Psychologist | 4910 N Chestnut Ave, Fresno, CA 93726-1852 | 2013-08-14 |
| 1184626012 | Marianne Jackson | Obstetrics & Gynecology | 133 Pleasant St, Berlin, NH 03570-2006 | 2005-08-11 |
| Street Address |
60 PLAZA ST E APT 1K |
| City | BROOKLYN |
| State | NY |
| Zip Code | 11238-5033 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003434135 | Shuowen Zhang | Social Worker | 535 Clinton Ave, 2nd Floor, Brooklyn, NY 11238 | 2020-07-06 |
| 1558909465 | Greene Ave Dental Pllc | Dentist | 335 Greene Ave, Brooklyn, NY 11238 | 2019-12-11 |
| 1558912311 | Haruka Ka | Social Worker | 535 Clinton Avenue, 2nd Floor, Brooklyn, NY 11238 | 2019-09-24 |
| 1407406978 | Zilin Li | Counselor | 535 Clinton Ave 2nd Floor, Community Counseling and Mediation, Brooklyn, NY 11238 | 2019-09-17 |
| 1770065492 | Batsheva Becher | Occupational Therapist | 419 Waverly Ave, Brooklyn, NY 11238 | 2018-08-29 |
| 1083194351 | Manhattan Integrative Gastroenterology | Internal Medicine | 550 Vanderbilt Ave Apt 803, Brooklyn, NY 11238 | 2018-08-16 |
| 1205328010 | Groundwork Therapy Psychological Services, Pllc | Psychologist | 1000 Dean Street, Suite 226, Brooklyn, NY 11238 | 2018-06-06 |
| 1053820464 | Darlene Latasha Parham | Registered Nurse | 400 Saint Marks Ave, 2a, Brooklyn, NY 11238 | 2017-09-28 |
| 1578085585 | Rocio Sorribas | Specialist | 244 Lafayette Avenue, Floor 1, Brooklyn, NY 11238 | 2017-07-11 |
| 1528509056 | Carolanne Marcantonio | Social Worker | 60 Plaza St East, Bs-1, Brooklyn, NY 11238 | 2017-03-16 |
| Find all providers in zip 11238 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700484623 | Rena Lee Miller | Psychologist | 252 N 6th St Apt 17, Brooklyn, NY 11211-3367 | 2020-10-13 |
| 1811594039 | Pinchus Feintuch | Psychologist | 1580 E 18th St Ste 101, Brooklyn, NY 11230-7261 | 2020-10-01 |
| 1497361349 | Ira Schwartz | Psychologist | 2350 Ocean Avenue, Apt. Phh, Brooklyn, NY 11229-3030 | 2020-09-16 |
| 1548873516 | James Delrey Grimaldi | Psychologist | 81 77th St, Brooklyn, NY 11209-2920 | 2020-08-28 |
| 1205445855 | Virtue Sankoh | Psychologist | 8 Vanderbilt Ave Apt 12a, Brooklyn, NY 11205-1226 | 2020-07-29 |
| 1053957662 | Rebecca Brodoff | Psychologist | 3692 Bedford Ave Ste P2, Brooklyn, NY 11229-1702 | 2019-11-19 |
| 1225671985 | Kenji Takeda | Psychologist | 68 35th St Unit 4, Brooklyn, NY 11232-2211 | 2019-10-24 |
| 1497397608 | Heidi Cox | Psychologist | 540 President St Fl 3, Brooklyn, NY 11215-1493 | 2019-10-09 |
| 1801352281 | Philip Jay Bender | Psychologist | 50 Ocean Pkwy Apt 6k, Brooklyn, NY 11218-1539 | 2019-02-11 |
| 1205328010 | Groundwork Therapy Psychological Services, Pllc | Psychologist | 1000 Dean Street, Suite 226, Brooklyn, NY 11238 | 2018-06-06 |
| Find all providers in BROOKLYN | ||||
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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.