WANDA JACKSON (NPI# 1386772812) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386772812 |
| Entity Type | Individual |
| Full Name | WANDA JACKSON |
| Practice Address |
5707 N 22nd Street Mental Health Care Inc Tampa FL 33610 |
| Practice Telephone | 8132722878 |
| Practice Fax Number | 8132723766 |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538525175 | Wanda Jackson | Home Health Aide | 1709 L St Ne, Washington, DC 20002-3021 | 2016-01-12 |
| 1710455100 | Wanda F. Jackson | Case Manager/Care Coordinator | 2017 Hudson Ln, Monroe, LA 71201-5705 | 2018-11-05 |
| 1982194635 | Wanda Marie Jackson | Licensed Practical Nurse | 3100 General De Gaulle Dr, New Orleans, LA 70114-6632 | 2018-05-17 |
| 1497287338 | Wanda Mercedes Jackson | Counselor | 1069 Broadway Ave Ste 201, Seaside, CA 93955-4995 | 2017-03-30 |
| 1497069900 | Wanda Elizabeth Jackson | Counselor | 2018 Rock Spring Rd, A6, Forest Hill, MD 21050-2631 | 2010-07-27 |
| 1043323504 | Wanda Kay Jackson | Dental Hygienist | 510 E Stoner Ave, #160, Shreveport, LA 71101-4243 | 2006-08-17 |
| Street Address |
5707 N 22ND STREET MENTAL HEALTH CARE INC |
| City | TAMPA |
| State | FL |
| Zip Code | 33610 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235246687 | Kay Ellen Mcauliffe | Social Worker | 5707 N 22nd Street, Tampa, FL 33610 | 2006-08-23 |
| 1932759149 | Mental Health Care, Inc | Clinic/Center | 5707 N 22nd Street, Tampa, FL 33610-4350 | 2019-09-19 |
| 1649535592 | Ruth E Rodriguez | Social Worker | 5707 N 22nd Street, Tampa, FL 33610-9209 | 2012-07-06 |
| 1013294933 | Sonya Frazier | Counselor | 5707 N 22nd Street, Tampa, FL 33610 | 2011-11-06 |
| 1770868796 | Alicia Lashawn Parks | Registered Nurse | 5707 N 22nd Street, Tampa, DC 33610 | 2011-10-21 |
| 1558665968 | Richard Frederick Miller | Psychiatry & Neurology | 5707 N 22nd Street, Mental Health Care, Inc., Tampa, FL 33610 | 2010-12-28 |
| 1689852725 | Elaine Daniels | Social Worker | 5707 N 22nd Street, Mental Health Care Inc, Tampa, FL 33610-4350 | 2008-01-31 |
| 1013121375 | Trevor P Nelson | Social Worker | 5707 N 22nd Street, Mental Health Care Inc, Tampa, FL 33610 | 2007-05-09 |
| 1023222411 | Julius Adams | Social Worker | 5707 N 22nd Street, Mental Health Care Inc, Tampa, FL 33610-4350 | 2007-05-09 |
| 1922212257 | Tara Capri Gimbel | Social Worker | 5707 N 22nd Street, Mental Health Care Inc, Tampa, FL 33610 | 2007-05-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184273161 | Mayra Iris Pesante Lopez | Behavior Technician | 10150 Highlands Manor Drive Suite 200, Tampa, FL 33610 | 2019-09-11 |
| 1902464381 | Ruth Hosen Milfort | Case Manager/Care Coordinator | 5707 N. 22nd Street, Tampa, FL 33610 | 2019-05-31 |
| 1265914626 | Universal Transportation Management Inc | Non-emergency Medical Transport (VAN) | 4108 N 22nd Street, Tampa, FL 33610 | 2018-09-02 |
| 1346759115 | Speedway Plus 2 Car Care Center LLCc | Residential Treatment Facility, Physical Disabilities | 8007 Glenoak Rd., Tampa, FL 33610 | 2017-09-25 |
| 1245757707 | Duy Dang | Behavioral Analyst | 4402 Claymore Dr Unit 203, Tampa, FL 33610 | 2017-08-25 |
| 1144745043 | Jonequa Baker | Home Health Aide | 709 North Castle Court, Tampa, FL 33610 | 2017-08-11 |
| 1619401338 | Dedicated Senior Medical Center East Tampa, LLC. | Non-Pharmacy Dispensing Site | 3128 East Hillsborough Avenue, Dedicated Senior Medical Center East Tampa, LLC., Tampa, FL 33610 | 2017-04-19 |
| 1669917423 | Olivia Anderson | Counselor | 10150 Highland Manor Dr Ste 200#108, Tampa, FL 33610 | 2017-01-03 |
| 1952779050 | Tampa Family Health Centers, Inc | Clinic/Center | 3100 E. Fletcher Avenue, Tampa, FL 33610 | 2015-09-04 |
| 1215303821 | Morissa Kidd | Technician, Other | 8062 Deerwood Circle, Tampa, FL 33610 | 2015-08-18 |
| Find all providers in zip 33610 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598365157 | Raenequa Baker | Social Worker | 5118 N 56th St Ste 111, Tampa, FL 33610-5440 | 2020-10-31 |
| 1851999429 | Jasmine Torres | Social Worker | 2807 W Busch Blvd, Tampa, FL 33618-4562 | 2020-10-15 |
| 1396350310 | Melania Jean Macip-billbe | Social Worker | 1924 Inner Oak Cir Apt 302, Tampa, FL 33619-7042 | 2020-09-15 |
| 1194339663 | Erin Mcentegart | Social Worker | 4719 W Fair Oaks Ave, Tampa, FL 33611-2117 | 2020-09-02 |
| 1144832213 | Holly J Wilson | Social Worker | 19194 Lake Audubon Dr, Tampa, FL 33647-3232 | 2020-08-20 |
| 1093327504 | Compassionate Counseling of Tampa Bay | Social Worker | 2702 S Beach Dr, Tampa, FL 33629-7503 | 2020-08-18 |
| 1396356192 | Silvia Ximena Perez | Social Worker | 7405 Albany Dr, Tampa, FL 33625-3803 | 2020-08-14 |
| 1164033080 | Tammy J Clevenger | Social Worker | 215 W Verne St, Tampa, FL 33606-2324 | 2020-08-13 |
| 1548878028 | Odat Coaching & Counseling | Social Worker | 812 W Mlk Blvd, Tampa, FL 33603-3338 | 2020-07-21 |
| 1205454329 | Amanda Jennings Farris | Social Worker | 611 S Glen Ave, Tampa, FL 33609-4607 | 2020-07-07 |
| Find all providers in TAMPA | ||||
Please comment or provide details below to improve the information on WANDA 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.