MARIELLE EMMA JACKSON (NPI# 1235778093) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235778093 |
| Entity Type | Individual |
| Full Name | MARIELLE EMMA JACKSON |
| Practice Address |
2617 General Pershing Blvd Oklahoma City OK 73107-6437 |
| Mailing Address |
Po Box 12978 Oklahoma City OK 73157-2978 |
| Practice Telephone | 4058582700 |
| Mailing Telephone | 4058582700 |
| Enumeration Date | 2019-12-26 |
| Last Update Date | 2019-12-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171M00000X | Case Manager/Care Coordinator | OK | Other Service Providers |
| Street Address |
2617 GENERAL PERSHING BLVD |
| City | OKLAHOMA CITY |
| State | OK |
| Zip Code | 73107-6437 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346245479 | Ahsan Y Khan | Psychiatry & Neurology | 2617 General Pershing Blvd, Oklahoma City, OK 73107-6437 | 2005-06-16 |
| 1801402334 | Karli Nicole Smith | Counselor | 2617 General Pershing Blvd, Oklahoma City, OK 73107-6437 | 2020-09-21 |
| 1306459193 | Kristen Dunham | Counselor | 2617 General Pershing Blvd, Oklahoma City, OK 73107-6437 | 2020-08-31 |
| 1043823206 | Cammie Lorraine Soriano | Case Manager/Care Coordinator | 2617 General Pershing Blvd, Oklahoma City, OK 73107-6437 | 2020-08-27 |
| 1386257673 | Abigail Kirsten Williams | Case Manager/Care Coordinator | 2617 General Pershing Blvd, Oklahoma City, OK 73107-6437 | 2020-08-26 |
| 1962014258 | Brandi Shearer | Counselor | 2617 General Pershing Blvd, Oklahoma City, OK 73107-6437 | 2020-08-19 |
| 1114538477 | Iridia Chavez Mares | Peer Specialist | 2617 General Pershing Blvd, Oklahoma City, OK 73107-6437 | 2020-08-11 |
| 1457961542 | Tiffany Jeanette Lefebvre | Peer Specialist | 2617 General Pershing Blvd, Oklahoma City, OK 73107-6437 | 2020-08-04 |
| 1790393262 | Amy Pavelka | Case Manager/Care Coordinator | 2617 General Pershing Blvd, Oklahoma City, OK 73107-6437 | 2020-07-21 |
| 1386262632 | Riley Jordan Copeland | Counselor | 2617 General Pershing Blvd, Oklahoma City, OK 73107-6437 | 2020-07-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144747999 | Ellen Rose Pochyly | Counselor | 2617 General Pershing Boulevard, Oklahoma City, OK 73107 | 2017-08-23 |
| 1609399906 | Carrie Ann Moore | Counselor | 2617 General Pershing Blvd., Oklahoma City, OK 73107 | 2017-07-19 |
| 1821511320 | Diana Lynn Spencer | Counselor | 2617generalpershingblvd, Oklahoma City, OK 73107 | 2017-07-18 |
| 1861859514 | Catherine Evans | Counselor | 500 N Meridian Ave Ste 409, Oklahoma City, OK 73107 | 2016-01-26 |
| 1871964551 | Kizzy Frazier | Student in an Organized Health Care Education/Training Program | 1233 N Warren Pl, Oklahoma City, OK 73107 | 2015-10-07 |
| 1538550629 | Oklahoma Department of Mental Health and Substance Abuse | Case Management | 2625 General Pershing Boulevard, Oklahoma City, OK 73107 | 2015-02-10 |
| 1952702276 | Andale Healthcare, LLC | Clinic/Center | 2305 N. Meridian, Oklahoma City, OK 73107 | 2014-09-05 |
| 1114339348 | John Walls | Psychologist | 2012 North Villa Avenue, Oklahoma City, OK 73107 | 2014-05-22 |
| 1376970517 | Latrice Warrior | Community/Behavioral Health | 2625 General Pershing Drive, Oklahoma City, OK 73107 | 2013-10-02 |
| 1326485541 | Debra Sue Vaughan | Counselor | 2617 Genral Pershing Blvd, Oklahoma City, OK 73107 | 2013-05-29 |
| Find all providers in zip 73107 | ||||
| Taxonomy Code | 171M00000X |
| Grouping | Other Service Providers |
| Classification | Case Manager/Care Coordinator |
| A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee’s progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management. |
| Notes: Source: CMS State Medicaid Manual Section 4442.3 [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508467994 | Yenth Matilde Chaidez | Case Manager/Care Coordinator | 10409 Casa Linda, Oklahoma City, OK 73139-5510 | 2020-11-03 |
| 1760082523 | Alimot Shadia L Karim | Case Manager/Care Coordinator | 1330 N Classen Blvd Ste 314, Oklahoma City, OK 73106-6834 | 2020-10-29 |
| 1336749852 | Reshanna Leshae Childs-russell | Case Manager/Care Coordinator | 10505 Windway Ave, Oklahoma City, OK 73162-8001 | 2020-10-26 |
| 1770182065 | Ifeoluwa Ochuwa Idode | Case Manager/Care Coordinator | 8135 Bigwood Drive, Oklahoma City, OK 73135 | 2020-10-19 |
| 1689281180 | Michael Antem Abane | Case Manager/Care Coordinator | 11018 N May Ave Apt 218, Oklahoma City, OK 73120-6310 | 2020-09-28 |
| 1932715091 | Robyn Olukaikpe | Case Manager/Care Coordinator | 1736 Ne 14th St, Oklahoma City, OK 73117-3616 | 2020-09-23 |
| 1720694961 | Latasha Howell | Case Manager/Care Coordinator | 2416 Nw 12th St, Oklahoma City, OK 73107-5608 | 2020-09-22 |
| 1982218822 | Sybril Renee Jeffery | Case Manager/Care Coordinator | 8700 Sw 39th St, Oklahoma City, OK 73179-3878 | 2020-09-08 |
| 1871106096 | Harmonious Healing Counseling, LLC | Case Manager/Care Coordinator | 10802 Quail Plaza Dr Ste 205, Oklahoma City, OK 73120-3121 | 2020-08-27 |
| 1407466816 | Stephanie Denise Hollier | Case Manager/Care Coordinator | 1126 Nw 81st St, Oklahoma City, OK 73114-1811 | 2020-08-01 |
| Find all providers in OKLAHOMA CITY | ||||
| City | OKLAHOMA CITY |
| Zip Code | 73107 |
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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.