ROSALYN ELOISE-NADINE JACKSON (NPI# 1215225438) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215225438 |
| Entity Type | Individual |
| Full Name | ROSALYN ELOISE-NADINE JACKSON |
| Credential | LPC |
| Practice Address |
110 Skyline Dr Russellville AR 72801-3362 |
| Mailing Address |
2400 S 48th St Springdale AR 72762-6683 |
| Practice Telephone | 4799675570 |
| Practice Fax Number | 4798905364 |
| Mailing Telephone | 4797502020 |
| Mailing Fax Number | 4797504843 |
| Enumeration Date | 2011-07-21 |
| Last Update Date | 2020-04-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YM0800X |
Counselor Specialization: Mental Health |
P1601006 | AR | Behavioral Health & Social Service Providers |
| Y | 101YP2500X |
Counselor Specialization: Professional |
P1601006 | AR | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235525031 | Rosalyn Diona Jackson | Social Worker | 100 River Place Dr, Detroit, MI 48207-4274 | 2015-04-09 |
| Street Address |
110 SKYLINE DR |
| City | RUSSELLVILLE |
| State | AR |
| Zip Code | 72801-3362 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588769491 | Richard L Moore | Counselor | 110 Skyline Dr, Russellville, AR 72801-3362 | 2006-09-14 |
| 1720618267 | Chantal Doucet-brice | Counselor | 110 Skyline Dr, Russellville, AR 72801-3362 | 2020-01-23 |
| 1659921914 | Mercedes A Bender | Counselor | 110 Skyline Dr, Russellville, AR 72801-3362 | 2019-09-18 |
| 1730749995 | Sydney Nicole Allen | Case Manager/Care Coordinator | 110 Skyline Dr, Russellville, AR 72801-3362 | 2019-06-19 |
| 1205301645 | Melinda L Arnold | Licensed Practical Nurse | 110 Skyline Dr, Russellville, AR 72801-3362 | 2018-10-12 |
| 1134615404 | Trakia Tucker | Case Manager/Care Coordinator | 110 Skyline Dr, Russellville, AR 72801-3362 | 2018-07-10 |
| 1134621451 | Tanner Leigh Yates | Case Manager/Care Coordinator | 110 Skyline Dr, Russellville, AR 72801-3362 | 2018-03-02 |
| 1306352943 | Leilani Harmon | Licensed Practical Nurse | 110 Skyline Dr, Russellville, AR 72801-3362 | 2017-12-19 |
| 1205359510 | Cody Layne Horn | Nurse Practitioner | 110 Skyline Dr, Russellville, AR 72801-3362 | 2017-07-18 |
| 1043749682 | Lindsey Howard | Case Manager/Care Coordinator | 110 Skyline Dr, Russellville, AR 72801-3362 | 2017-06-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962002782 | Randy Paul Stayton | Pharmacist | 2109 W Main, Russellville, AR 72801 | 2020-10-30 |
| 1871134825 | Just Spreading Love Senior Care LLC | Student in an Organized Health Care Education/Training Program | 1411 N. Pittsburg Avenue, Russellville, AR 72801 | 2019-10-01 |
| 1124670369 | Richard L Morgan Dds Pa | Dentist | 1700 West C Place, Russellville, AR 72801 | 2019-07-09 |
| 1407342371 | Andrew James Hickman | Optometrist | 2711 E Parkway Drive, Russellville, AR 72801 | 2018-07-03 |
| 1154859833 | Felicia Head | Speech-Language Pathologist | 220 W 10th St., Russellville, AR 72801 | 2017-05-25 |
| 1295281293 | Arkansas Liver and Gastroenterology, P.a. | Internal Medicine | 1605 West Main Street, Russellville, AR 72801 | 2016-08-30 |
| 1467802405 | Kah Development 4, LLC | Hospice Care, Community Based | 3801 W Main St Ste A, Russellville, AR 72801 | 2016-06-21 |
| 1871904839 | Sleep Partners, LLC | Clinic/Center | 1310 West B Street, Suite A, Russellville, AR 72801 | 2014-05-13 |
| 1942647029 | Rpi Sleep Complete LLC | Clinic/Center | 1310 West Main Street, Suite 201, Russellville, AR 72801 | 2013-05-29 |
| 1184967291 | Amedco Arkansas Pllc | Optometrist | 302 N. Phoenix Ave., Clark Eye Clinic, Russellville, AR 72801 | 2013-03-27 |
| Find all providers in zip 72801 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922527027 | Sarah Huey | Counselor | 1505 S. Oswego Ave., Russellville, AR 72802 | 2017-09-11 |
| 1932589520 | Valerie Couture | Counselor | 144 Homer Roach Ln, Russellville, AR 72802-8356 | 2015-06-09 |
| 1851704159 | Amanda Roberts | Counselor | 110 S. Commerce Ave, Russellville, AR 72801-5939 | 2014-06-04 |
| 1699199398 | Sherry Tatman | Counselor | 814 W B St, Russellville, AR 72801-3610 | 2014-02-15 |
| 1669741211 | Whitney Emerson | Counselor | 1200 S Elmira Ave, Russellville, AR 72802-9646 | 2011-12-27 |
| 1083223010 | Gerald Dwayne Webb | Counselor | 1305 E Main St, Russellville, AR 72801-5322 | 2020-07-27 |
| 1114551868 | Harold Wayne Taylor Jr. | Counselor | 814 W B St, Russellville, AR 72801-3610 | 2020-03-02 |
| 1851871115 | Bobbie Campbell | Counselor | 1200 S Elmira Ave, Russellville, AR 72802-9646 | 2018-08-16 |
| 1376993410 | Beth Morris | Counselor | 1110 W B St, Russellville, AR 72801-3506 | 2016-06-20 |
| 1861872277 | Jeffrey Meade | Counselor | 237 E 6th St, Russellville, KY 42276-1917 | 2015-06-02 |
| Find all providers in RUSSELLVILLE | ||||
| City | RUSSELLVILLE |
| Zip Code | 72801 |
Please comment or provide details below to improve the information on ROSALYN ELOISE-NADINE JACKSON.
| 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.