MR. COURTNEY LARESIC JACKSON


Address: 608 10th St, Sacramento, CA 95814-0712
Phone: 9164412933

MR. COURTNEY LARESIC JACKSON (NPI# 1417076241) 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) 1417076241
Entity Type Individual
Full Name MR. COURTNEY LARESIC JACKSON
Practice Address 608 10th St
Sacramento
CA 95814-0712
Mailing Address 3372 Rivermont St
West Sacramento
CA 95691-5443
Practice Telephone 9164412933
Mailing Telephone 9163719338
Enumeration Date 2007-03-29
Last Update Date 2007-07-08
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 101Y00000X Counselor Behavioral Health & Social Service Providers

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1689824302 Courtney Brooke Jackson Naturopath 511 Sw 10th Ave Ste 801, Portland, OR 97205-2709 2008-09-30
1063606846 Courtney Lara Jackson Counselor 1801 Vincente St, San Francisco, CA 94116-2923 2007-09-05
1164029245 Courtney Jackson Speech-Language Pathologist 65 Court St, Brooklyn, NY 11201-4916 2020-10-02
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Office Location

Street Address 608 10TH ST
City SACRAMENTO
State CA
Zip Code 95814-0712

Providers in the same location

NPI Name Taxonomy Address Enumeration
1598868663 Pamela F Helm Counselor 608 10th St, Sacramento, CA 95814-0712 2006-09-06
1598088452 Melissa Pena Counselor 608 10th St, Sacramento, CA 95814-0712 2010-03-08
1598098675 Mauricio Esteban Verduzco Counselor 608 10th St, Sacramento, CA 95814-0712 2009-09-08
1306029368 Don Paul Cooney Case Manager/Care Coordinator 608 10th St, Sacramento, CA 95814-0712 2007-12-13
1093904765 Duane Kenney Neumeier Case Manager/Care Coordinator 608 10th St, Sacramento, CA 95814 2007-10-18
1841488046 Nicole Simone Walker Case Manager/Care Coordinator 608 10th St, Sacramento, CA 95814-0712 2007-10-12
1740486596 Carolyn Nevaoun Bussell Licensed Vocational Nurse 608 10th St, Sacramento, CA 95814-0712 2007-06-26
1730307034 Aracely Villa Counselor 608 10th St, Sacramento, CA 95814-0712 2007-04-23
1538280813 Laquisha Simone Spagner Case Manager/Care Coordinator 608 10th St, Sacramento, CA 95814-0712 2007-04-03
1972622736 El Hogar Inc Case Management 608 10th St, Sacramento, CA 95814-0712 2007-03-29
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1801435631 County of Sacramento Clinic/Center 651 I Street, Sacramento, CA 95814 2019-12-26
1376033746 Jenna Pettus Nurse Practitioner 711 14th St, Apt 11, Sacramento, CA 95814 2018-05-11
1306269667 First Advocate Home Care In Home Supportive Care 1215 K Street, 17th Floor, Sacramento, CA 95814 2014-01-22
1063752350 Brian C. Steele Dds A Professional Corporation Dentist 1105 E Street, Sacramento, CA 95814 2013-02-22
1265777692 Wellspace Health Clinic/Center 631 H St, Sacramento, CA 95814 2012-12-12
1407117823 Richard Lee Bauer Internal Medicine 651 I St., Sacramento, CA 95814 2012-06-01
1851669949 Heaaring Healthcare Provider of California Audiologist One Capitol Mall, Suite 320, Sacramento, CA 95814 2011-12-05
1114254935 Robert D Canning Psychologist 501 J Street, Suite 530, California Department of Corrections & Rehabilitation, Sacramento, CA 95814 2009-11-16
1407035488 Donald Herbert Hodges Case Manager/Care Coordinator 1420 E Street Apt # B, Sacramento, CA 95814 2007-10-26
1255537536 River Oak Center for Children Clinic/Center 1238 S Street, Sacramento, CA 95814 2007-06-25
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Taxonomy Information

Taxonomy Code 101Y00000X
Grouping Behavioral Health & Social Service Providers
Classification Counselor

Taxonomy Definition

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.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1952909210 Christopher Shirey Counselor 1618 Alhambra Blvd, Sacramento, CA 95816-7601 2020-10-09
1043824337 Adonis R Johnson Counselor 2500 Marconi Ave, Sacramento, CA 95821-4853 2020-09-03
1528676160 Hope Lynn Mulligan Counselor 2750 Sutterville Rd # Cottage1, Sacramento, CA 95820-1024 2020-07-20
1235756891 Guneet Kaur Counselor 8247 E Stockton Blvd # 4, Sacramento, CA 95828-8200 2020-06-30
1073132635 Gage Michael Smith Counselor 7055 Woodrick Way, Sacramento, CA 95842-2246 2020-04-14
1952935876 Crystal S Nicholas Counselor 845 Fulton Ave Apt 1051, Sacramento, CA 95825-6434 2020-02-29
1255975827 Molly Ritter Counselor 650 Bercut Dr Ste C, Sacramento, CA 95811-0100 2019-11-06
1396393823 Lannon Hope Gustafson Counselor 8573 E Southgate Dr., Sacramento, CA 95823 2019-08-28
1821642265 Courtney Nelson Counselor 7818 Bardu Ln, Sacramento, CA 95829 2019-07-24
1669948212 Micaela Badue Counselor 401 S St., Sacramento, CA 95811 2018-10-22
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Competitor

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City SACRAMENTO
Zip Code 95814

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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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