SAMANTHA RAE JACKSON (NPI# 1245607357) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245607357 |
| Entity Type | Individual |
| Full Name | SAMANTHA RAE JACKSON |
| Credential | LPC |
| Practice Address |
695 South St Chardon OH 44024-1474 |
| Mailing Address |
41 Marshall Ave Apt. 1 Akron OH 44303-1412 |
| Practice Telephone | 4402861631 |
| Mailing Telephone | 3305022532 |
| Enumeration Date | 2015-08-24 |
| Last Update Date | 2015-08-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | C.1100378 | OH | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649804360 | Samantha Jackson | Home Health Aide | 920 Waycross Rd, Cincinnati, OH 45240-3071 | 2020-03-03 |
| 1215408489 | Samantha Jackson | Licensed Vocational Nurse | 6100 Ashbury St Apt 3114, North Richland Hills, TX 76180-2010 | 2018-12-16 |
| 1861960221 | Samantha Rae Jackson | Nurse Practitioner | 320 Sumner Blvd, Collinsville, IL 62234-1929 | 2018-11-05 |
| 1104806967 | Samantha Jackson | Family Medicine | 415 W Forest Ln, Hobart, OK 73651-1645 | 2006-01-18 |
| 1710527387 | Samantha Jackson | Behavior Technician | 21230 Kingsland Blvd Ste 100a, Katy, TX 77450-5899 | 2020-01-13 |
| 1609438225 | Samantha Lachelle Jackson | Counselor | 1900 N Howard St Ste 300, Baltimore, MD 21218-5909 | 2019-07-03 |
| 1174906549 | Samantha L Jackson | Counselor | 1470 Civic Ct Ste 110, Concord, CA 94520-5290 | 2015-07-03 |
| 1558615583 | Samantha Jackson | Speech-Language Pathologist | 4609 San Dario Ave Ste 9, Laredo, TX 78041-5773 | 2012-10-29 |
| 1801191754 | Samantha Jackson | Physician Assistant | 1818 Richardson Dr, Reidsville, NC 27320-5451 | 2011-01-24 |
| 1457652489 | Samantha R. Jackson | Licensed Practical Nurse | 5285 Lewiston Rd, Lewiston, NY 14092-1942 | 2010-11-08 |
| Street Address |
695 SOUTH ST |
| City | CHARDON |
| State | OH |
| Zip Code | 44024-1474 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538345335 | Bernadette M Charles | Counselor | 695 South St, Chardon, OH 44024-1474 | 2008-01-11 |
| 1730792391 | Caelin Mcmanis | Case Manager/Care Coordinator | 695 South St, Chardon, OH 44024-1474 | 2020-08-24 |
| 1992315493 | Alexis Victoria Hassett | Case Manager/Care Coordinator | 695 South St, Chardon, OH 44024-1474 | 2020-08-09 |
| 1245860873 | Katelyn Maureen Toohig | Counselor | 695 South St, Chardon, OH 44024-1474 | 2020-01-23 |
| 1609438605 | Tiffany Stute Bolton | Counselor | 695 South St, Chardon, OH 44024-1474 | 2019-07-01 |
| 1205496130 | Stephanie Quinn Podlogar | Counselor | 695 South St, Ste 6, Chardon, OH 44024-1474 | 2019-06-13 |
| 1497312292 | Andrew Britten | Case Manager/Care Coordinator | 695 South St, Chardon, OH 44024-1474 | 2019-05-28 |
| 1265990691 | Michelle M Maneage | Case Manager/Care Coordinator | 695 South St, Chardon, OH 44024-1474 | 2019-03-05 |
| 1669946224 | John Dorsey | Peer Specialist | 695 South St, Chardon, OH 44024-1474 | 2019-01-17 |
| 1417405507 | Krystal Klingemier | Counselor | 695 South St, Chardon, OH 44024-1474 | 2016-09-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992336770 | Amanda Nicole Nelson | Technician, Other | 133 Up Main St, Chardon, OH 44024 | 2020-01-30 |
| 1679067011 | Janai Marshae Seng | Dentist | 401 South Street #3a, Chardon, OH 44024 | 2018-06-19 |
| 1376036475 | Kasandra Leigh Chapman | Social Worker | 12941 Ravenna Road, Chardon, OH 44024 | 2018-06-13 |
| 1275068652 | Danielle Tilton | Nurse Practitioner | 531 Fifth Ave, Chardon, OH 44024 | 2017-04-24 |
| 1881057040 | Erin Marie Moore | Counselor | 203 Main St., Chardon, OH 44024 | 2016-04-04 |
| 1649689886 | Hope Anne Super | Speech-Language Pathologist | 100 7th Av Suite 255, Chardon, OH 44024 | 2014-08-12 |
| 1740600022 | Elisha Tzvi Fredman | Student in an Organized Health Care Education/Training Program | 13207 Chardon Road, Ravenna, OH 44024 | 2014-04-24 |
| 1083039309 | Jamie Delvecchio | Family Medicine | 150 7th Ave Ste 200, Chardon, OH 44024 | 2014-02-24 |
| 1174947212 | Frank Scarano | Psychologist | 470 Center Street, Chardon, OH 44024 | 2014-02-10 |
| 1659706497 | Jamie Henderson | Physical Therapy Assistant | 9348 South Brown Rd, Chardon, OH 44024 | 2013-09-12 |
| Find all providers in zip 44024 | ||||
| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053712257 | Evyn Karlosky | Counselor | 9600 Old State Rd, Chardon, OH 44024-9260 | 2014-09-08 |
| 1134337488 | Marie E Burke | Counselor | 113 N Hambden St, Chardon, OH 44024-1166 | 2007-05-18 |
| 1730786088 | Joseph Miller | Counselor | 695 South St Ste 6, Chardon, OH 44024-1474 | 2020-10-08 |
| 1962062513 | Nickole Bollini | Counselor | 695 South St Ste 6, Chardon, OH 44024-1474 | 2019-06-17 |
| 1205496130 | Stephanie Quinn Podlogar | Counselor | 695 South St, Ste 6, Chardon, OH 44024-1474 | 2019-06-13 |
| 1356909634 | Megan Mitcheltree | Counselor | 695 South St Ste 6, Chardon, OH 44024-1474 | 2019-06-03 |
| 1932639457 | Kayla Marcie Stefancic | Counselor | 12557 Ravenwood Dr, Chardon, OH 44024-9009 | 2017-06-18 |
| 1952839227 | Rachel Schneider | Counselor | 12557 Ravenwood Dr, Chardon, OH 44024-9009 | 2017-05-31 |
| 1750815452 | Brock Owen Bodenbender | Counselor | 12557 Ravenwood Dr, Chardon, OH 44024-9009 | 2017-04-19 |
| 1568829075 | Rebecca Nicely | Counselor | 12557 Ravenwood Dr, Chardon, OH 44024 | 2016-01-28 |
| Find all providers in CHARDON | ||||
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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.