MR. JAISSEN M JACKSON


Address: 194 Webster Ave, Providence, RI 02909-3818
Phone: 4012610321

MR. JAISSEN M JACKSON (NPI# 1275074171) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1275074171
Entity Type Individual
Full Name MR. JAISSEN M JACKSON
Practice Address 194 Webster Ave
Providence
RI 02909-3818
Mailing Address 530 N Main St
Providence
RI 02904-5762
Practice Telephone 4012610321
Mailing Telephone 4012764100
Mailing Fax Number 4012764124
Enumeration Date 2017-03-13
Last Update Date 2019-10-23
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 101Y00000X Counselor Behavioral Health & Social Service Providers
Y 101YM0800X Counselor
Specialization: Mental Health
MHC01094 RI Behavioral Health & Social Service Providers

Office Location

Street Address 194 WEBSTER AVE
City PROVIDENCE
State RI
Zip Code 02909-3818

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1578021754 Roberta Bellas Portugal Registered Nurse Behave Care, 188 Valley St, Providence, RI 02909 2019-03-07
1912137324 Catherine Elaine Tuttle Social Worker 623 Atwells Avenue, Suite 201, Providence, RI 02909 2009-07-20
1477736452 City Dental, LLC Dentist 314f Pocasset Avenue, Providence, RI 02909 2007-12-12
1245449651 Walter R. Vandyck Occupational Therapist Springfield Middle School, Providene School Department, 152 Springfield St, Providence, RI 02909 2007-05-22
1780805283 Marcel A Trisvan Counselor Codac Providence, 349 Huntington Ave, Providence, RI 02909 2007-05-01
1215153945 Codac Inc Peer Specialist 349 Huntington Ave, Codac Providence, Providence, RI 02909 2007-04-18
1316076342 Mulak Chiropractic Center Inc Chiropractor 411 Broadway, Providence, RI 02909 2007-03-05
1710042742 Michael Antonio Pensa Chiropractor 45 Eagle St Bld J Unit 100, Providence, RI 02909 2006-12-27
1780768234 Providence Community Action Case Management 662 Hartford Avenue, Providence, RI 02909 2006-10-24
1881629608 Cora Brigid Mayer Counselor 623 Atwells Ave., Communities for People, Inc., Providence, RI 02909 2006-07-11
Find all providers in zip 02909

Taxonomy Information

Taxonomy Code 101YM0800X
Grouping Behavioral Health & Social Service Providers
Classification Counselor
Specialization Mental Health

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1932738416 Rhea Bhatia Counselor 219 Leah St Unit 2, Providence, RI 02908-3907 2020-04-06
1568098721 Roisin Mcgettigan Counselor 365 Hope St, Providence, RI 02906-1633 2020-03-19
1962049932 Wholelife Family Wellness Clinic of Providence Pllc Counselor 169 N Gateway Dr. Suite 170, Providence, UT 84332 2019-12-09
1679117675 Abbey Seabury Chrupcala Counselor 382 Thayer St, Providence, RI 02906-1558 2019-11-01
1205392891 Sara De Carvalho Counselor 21 Pratt St # 5, Providence, RI 02906-1424 2019-02-19
1376008078 Rebecca Zub Counselor 58 Taft Ave Apt 9, Providence, RI 02906-3473 2019-02-06
1821509944 Hologram Central Counselor 44 Barbara St Unit 1, Providence, RI 02909-5110 2017-10-16
1497273932 Ashley Jasmine Williams Counselor 131 Ledge St, Providence, RI 02904-1532 2017-09-05
1912448481 Catherine Allard Counselor 225 Carpenter St, Providence, RI 02903-3044 2017-03-16
1649711144 Kerri Peterson Weaver Counselor 400 Reservoir Ave Ste Llo, Providence, RI 02907-3595 2017-03-16
Find all providers in PROVIDENCE

Competitor

Search similar providers

City PROVIDENCE
Zip Code 02909

Improve Information

Please comment or provide details below to improve the information on MR. JAISSEN M JACKSON.

Dataset Information

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.

Trending Searches