CLARISSA JACKSON (NPI# 1417454315) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417454315 |
| Entity Type | Individual |
| Full Name | CLARISSA JACKSON |
| Other Name | CLARISSA MOSES |
| Credential | LCDC |
| Practice Address |
3080 W Washington St Ste B Stephenville TX 76401-3756 |
| Practice Telephone | 2549655515 |
| Mailing Telephone | 2549655515 |
| Enumeration Date | 2018-04-09 |
| Last Update Date | 2018-04-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
12992 | TX | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851907364 | Clarissa Jackson | Counselor | 10140 Hawkeye Dr, Charlotte, NC 28273-4536 | 2020-09-20 |
| 1467953364 | Clarissa Jackson | Behavior Technician | 1558 B St, 201, Hayward, CA 94541-3052 | 2018-02-26 |
| Street Address |
3080 W WASHINGTON ST STE B |
| City | STEPHENVILLE |
| State | TX |
| Zip Code | 76401-3756 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700421930 | Catherine Johns | Speech-Language Pathologist | 418 County Road 428, # 418, Stephenville, TX 76401 | 2019-11-12 |
| 1457828683 | Allison Ann Luedeker | Nurse Practitioner | 950 Bluebonnet Street, Stephenville, TX 76401 | 2018-10-25 |
| 1326528092 | Stephanie Renee Drake | Speech-Language Pathologist | 1739 Bull Elk Dr, Stephenville, TX 76401 | 2018-08-21 |
| 1528564804 | Dylan D Dawson | Specialist/Technologist | 1590 Washington St, Stephenville, TX 76401 | 2018-04-04 |
| 1730680117 | Alison Lea Reynolds | Licensed Vocational Nurse | 208 Prairie Wind, Stephenville, TX 76401 | 2018-02-22 |
| 1760855977 | Gina Neri | Physical Therapy Assistant | 1670 West Lingley Rd, Stephenville, TX 76401 | 2015-11-10 |
| 1104216886 | Edmund Case Horton | Rehabilitation Counselor | 2443-8 Nw Loop, Stephenville, TX 76401 | 2015-02-02 |
| 1043648215 | Cross Timbers Imaging | Radiology | 561 N. Graham St, Stephenville, TX 76401 | 2013-10-24 |
| 1306273362 | Kelley Camille Verpooten | Counselor | 239 S. Virginia Street, Stephenville, TX 76401 | 2013-10-04 |
| 1477735140 | Nanette V Evans M.d., P.a. | Radiology | 150 Rivernorth Blvd., Stephenville, TX 76401 | 2007-12-04 |
| Find all providers in zip 76401 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306273362 | Kelley Camille Verpooten | Counselor | 239 S. Virginia Street, Stephenville, TX 76401 | 2013-10-04 |
| 1912067380 | Pat Lovell | Counselor | 409 S Graham St, Stephenville, TX 76401-4425 | 2006-12-08 |
| 1649726050 | Justina Arnett | Counselor | 239 S Virginia St, Stephenville, TX 76401-4344 | 2016-08-27 |
| 1306116967 | Cassandra Sue Hanna | Counselor | 239 S Virginia St, Stephenville, TX 76401-4344 | 2012-01-12 |
| 1255601902 | Rhonda Nell Evans | Counselor | 409 S Graham St, Stephenville, TX 76401-4425 | 2012-01-11 |
| 1972734960 | Martin D Phillips | Counselor | 239 S Virginia St, Stephenville, TX 76401-4344 | 2009-08-07 |
| 1528237666 | Brenda L Hansen | Counselor | 239 S Virginia St, Stephenville, TX 76401-4344 | 2008-02-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740881655 | Frances Charline Lee Cole | Counselor | 6238 Raymond Rd, Kaufman, TX 75142-7624 | 2020-11-06 |
| 1063013985 | Kyle Allan Mccall | Counselor | 5015 S Ih 35 Frontage Rd, Suite 200, Austin, TX 78744 | 2020-11-06 |
| 1639770969 | Fadya Therapy Pllc | Counselor | 1452 Wild Basin Ldg, Austin, TX 78746-2700 | 2020-11-03 |
| 1679173728 | Darlene Kearney | Counselor | 2626 S Loop W Ste 174, Houston, TX 77054-2873 | 2020-10-28 |
| 1346849148 | Priscilla Rosas | Counselor | 8431 Chivalry St, San Antonio, TX 78254 | 2020-10-22 |
| 1649879586 | Nicole Trevino | Counselor | 12631 E Clark Rd, La Feria, TX 78559-4528 | 2020-10-21 |
| 1144829060 | Reffitt Counseling, Pllc | Counselor | 301 S Rogers St Ste 106, Waxahachie, TX 75165-3682 | 2020-10-21 |
| 1548868664 | Michelle Villarreal | Counselor | 4720 Box Canyon Dr, Temple, TX 76502-7311 | 2020-10-12 |
| 1275131559 | Debbie Jo Stuard | Counselor | Debbie Stuard Lcdc/ma, 255 Airtex, Houston, TX 77090-7753 | 2020-10-09 |
| 1558968289 | Alexandra Glenn | Counselor | 3310 Louisiana St Apt 2304, Houston, TX 77006-6637 | 2020-10-06 |
| Find all providers with the same taxonomy | ||||
| City | STEPHENVILLE |
| Zip Code | 76401 |
Please comment or provide details below to improve the information on CLARISSA 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.