LAVONNE JACKSON


Address: 622 S Betty Ln Apt 2, Clearwater, FL 33756-6080
Phone: 7577699056

LAVONNE JACKSON (NPI# 1316576937) 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) 1316576937
Entity Type Individual
Full Name LAVONNE JACKSON
Practice Address 622 S Betty Ln Apt 2
Clearwater
FL 33756-6080
Mailing Address Po Box 7215
Clearwater
FL 33758-7215
Practice Telephone 7577699056
Mailing Telephone 7577699056
Enumeration Date 2020-04-06
Last Update Date 2020-04-06
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 101YM0800X Counselor
Specialization: Mental Health
18659 FL Behavioral Health & Social Service Providers

Other Provider Identifier

State Issuer Identifier Type Code
FL REGISTER MENTAL HEALTH COUNSELOR INTER 18659 01

Office Location

Street Address 622 S BETTY LN APT 2
City CLEARWATER
State FL
Zip Code 33756-6080

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NPI Name Taxonomy Address Enumeration
1659998060 Guidewell Emergency Medicine Doctors, LLC Clinic/Center 1603 Missouri Ave, Clearwater, FL 33756 2020-07-01
1578104527 M.k. El-yousef, M.d. LLC Psychiatry & Neurology 1555 S. Ft Harrison Ave, Clearwater, FL 33756 2019-10-01
1124672670 Kayla Marie Flook Counselor 1106 Druid Rd S Suite 201, Clearwater, FL 33756 2019-08-01
1285192989 Amy Elizabeth Dickson Social Worker 1260 S Mlk Jr Ave Ste D, Clearwater, FL 33756 2019-03-12
1548789951 J. Carson Woolwine O.d. Pllc. Optometrist 912 S. Missouri Ave., Clearwater, FL 33756 2017-09-18
1760912349 Kelly Morrissey Counselor 1240 South Fort Harrison Ave., Clearwater, FL 33756 2017-06-15
1972033744 Edward Lewis Smith Audiologist-Hearing Aid Fitter 820 S Fort Harrison, Clearwater, FL 33756 2017-06-14
1700310422 Dedicated Senior Medical Center Clearwater, LLC. Non-Pharmacy Dispensing Site 855 S Highland Avenue, Dedicated Senior Medical Center St. Clearwater, LLC., Clearwater, FL 33756 2017-04-19
1306268339 Theresa Anne Ritz Counselor 1260 S Martin Luther King Jr Ave Ste D, Clearwater, FL 33756 2014-01-10
1649513276 Kerry Eileen Reller Family Medicine 708 Druid Rd. E, Clearwater, FL 33756 2013-04-02
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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
1629682760 Joseph F Delgiorno Counselor 2370 Jamaican St Apt 20, Clearwater, FL 33763-3034 2020-09-05
1124638408 Carlos Enrique Mendez Counselor 2690 Drew St Apt 858, Clearwater, FL 33759-3111 2020-08-03
1124672670 Kayla Marie Flook Counselor 1106 Druid Rd S Suite 201, Clearwater, FL 33756 2019-08-01
1932626546 Sheryl Foster Counselor 1106 Druid Rd S Ste 201, Clearwater, FL 33756-3807 2017-08-24
1346767910 David Joshua Kent Counselor 2750 N Mcmullen Booth Rd Ste 102a, Clearwater, FL 33761-3362 2017-08-24
1437675501 Stephani Jo Mendizabal Counselor 2725 Park Dr Ste 2a, Clearwater, FL 33763-1023 2017-08-20
1760912349 Kelly Morrissey Counselor 1240 South Fort Harrison Ave., Clearwater, FL 33756 2017-06-15
1184160590 Jaclyn Matthews Counselor 3000 Gulf To Bay Blvd Ste 312, Clearwater, FL 33759-4304 2017-01-09
1548711054 William Mccormack Jr. Counselor 2430 Estancia Blvd Ste 106, Clearwater, FL 33761-2607 2016-10-19
1205201613 Joshua Roop Counselor 2725 Park Dr Ste 2f, Clearwater, FL 33763 2015-12-10
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Competitor

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City CLEARWATER
Zip Code 33756

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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.

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