MR. BRANDON CLARK JACKSON (NPI# 1427611151) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427611151 |
| Entity Type | Individual |
| Full Name | MR. BRANDON CLARK JACKSON |
| Credential | LMSW |
| Practice Address |
42-77 65th Place Woodside NY 11377-5054 |
| Mailing Address |
517 E 77th St Apt 1i New York NY 10075-8865 |
| Practice Telephone | 7184292000 |
| Mailing Telephone | 9174998149 |
| Enumeration Date | 2019-04-18 |
| Last Update Date | 2019-04-18 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 104100000X | Social Worker | 101654-1 | NY | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275046153 | Brandon Lamarr Jackson | Home Health Aide | 400 Brunswick St, Mooresville, NC 28115-2246 | 2017-11-14 |
| 1083163521 | Brandon Jackson | Student in an Organized Health Care Education/Training Program | 122 Lanier Dr, 322c, Statesboro, GA 30458-0804 | 2016-09-26 |
| 1881030310 | Brandon Christopher Jackson | Military Health Care Provider | 6810 Camphor Ln, San Diego, CA 92139 | 2013-05-10 |
| 1861753949 | Brandon Joshua Jackson | Dentist | 70 Virginia Ave, Staten Island, NY 10305-1748 | 2012-06-05 |
| 1952340671 | Brandon Leroy Jackson | Physical Therapist | 4765 S. Durango Dr., Ste 106, Las Vegas, NV 89147 | 2006-06-06 |
| 1457994634 | Brandon Jackson | Rehabilitation Practitioner | 1873 W 54th St, Los Angeles, CA 90062-2604 | 2019-10-21 |
| 1831658640 | Brandon Thomas Jackson | Plastic Surgery | 251 E Huron St, Chicago, IL 60611-3055 | 2019-03-19 |
| 1164952644 | Brandon Scott Jackson | Behavior Technician | 1200 W South Boulder Rd Ste 204, Lafayette, CO 80026-2833 | 2017-06-15 |
| 1578896031 | Brandon T. Jackson | Chiropractor | 1258 Bryan Rd, O Fallon, MO 63366-3771 | 2009-09-15 |
| Street Address |
42-77 65TH PLACE |
| City | WOODSIDE |
| State | NY |
| Zip Code | 11377-5054 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831516343 | Catherine Ponzi | Case Manager/Care Coordinator | 42-77 65th Place, Woodside, NY 11377 | 2014-03-21 |
| 1336770064 | Melissa Shelton | Behavior Technician | 42-77 65th Place, Woodside, NY 11377-5054 | 2020-01-31 |
| 1750911418 | Sheryl E Harvin | Behavior Technician | 42-77 65th Place, Woodside, NY 11377 | 2020-01-22 |
| 1104466465 | Amanda Alfonso | Physical Therapist | 42-77 65th Place, Woodside, NY 11377 | 2020-01-14 |
| 1417508219 | Felicity Nduku | Social Worker | 42-77 65th Place, Woodside, NY 11377 | 2019-09-23 |
| 1720637838 | Samuel Newman | Social Worker | 42-77 65th Place, Woodside, NY 11377 | 2019-09-11 |
| 1265085005 | Venecia Alicia Golding | Registered Nurse | 42-77 65th Place, Woodside, NY 11377 | 2019-07-21 |
| 1689239360 | Kate Henry | Social Worker | 42-77 65th Place, Woodside, NY 11377 | 2019-05-07 |
| 1902365679 | Natasha Harris | Social Worker | 42-77 65th Place, Woodside, NY 11377 | 2019-03-13 |
| 1962979161 | Elizabeth Hodgens | Registered Nurse | 42-77 65th Place, Woodside, NY 11377 | 2018-10-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295353738 | Qw Pharmacy Inc | Pharmacy | 54-03 Roosevelt Ave., Woodside, NY 11377 | 2020-07-10 |
| 1689214348 | Reilly Abbott | Social Worker | 42-77 65th Pl, Woodside, NY 11377 | 2020-01-10 |
| 1134767833 | Queens Boulevard Chiropractic P.C. | Chiropractor | 51-27 Queens Blvd, 2nd Fl 2c, Woodside, NY 11377 | 2019-12-13 |
| 1497313399 | Aftab Ahmed | Pharmacist | 5801 Woodside Ave # 3, Woodside, NY 11377 | 2019-06-05 |
| 1780240606 | Simple Therapy Pt PC | Clinic/Center | 49-03 69th Street, Unit B, Woodside, NY 11377 | 2019-05-15 |
| 1386115046 | Andrea Charidemou | Social Worker | 42-77 62nd Pl, Woodside, NY 11377 | 2018-12-06 |
| 1952870198 | American United Medicine PC | Allergy & Immunology | 5314 Roosevelt Ave., Ste 302, Rm 5, Woodside, NY 11377 | 2018-11-16 |
| 1396226999 | Michelle Xian | Social Worker | 42-77 65th Pl., Woodside, NY 11377 | 2018-08-22 |
| 1598253759 | Noel Melon Nuevas | Physical Therapy Assistant | 63 08 39th Ave, Woodside, NY 11377 | 2018-04-24 |
| 1992206585 | Sixtieth Family Dental,pllc | Clinic/Center | 6019 Roosevelt Ave Ste 225, Woodside, NY 11377 | 2018-02-28 |
| Find all providers in zip 11377 | ||||
| Taxonomy Code | 104100000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| A social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public. |
| Notes: Source: National Association of Social Workers, 2009 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689214348 | Reilly Abbott | Social Worker | 42-77 65th Pl, Woodside, NY 11377 | 2020-01-10 |
| 1386115046 | Andrea Charidemou | Social Worker | 42-77 62nd Pl, Woodside, NY 11377 | 2018-12-06 |
| 1396226999 | Michelle Xian | Social Worker | 42-77 65th Pl., Woodside, NY 11377 | 2018-08-22 |
| 1467948851 | Angela Gralian | Social Worker | 4172 54th St, Woodside, NY 11377-4647 | 2018-07-09 |
| 1932651767 | Xiomara Borja | Social Worker | 67-14 41 Avenue, Woodside, NY 11377 | 2016-10-27 |
| 1528516051 | Mohanraj Rahiman | Social Worker | 5915 47th Ave Apt 1e, Woodside, NY 11377-5601 | 2016-09-13 |
| 1043603087 | Lucy Kay Strand | Social Worker | 289 Miramontes Rd, Woodside, CA 94062-3625 | 2015-03-16 |
| 1124397948 | Miao Yu | Social Worker | 4801 65th Pl Apt 6, Woodside, NY 11377-5803 | 2011-12-22 |
| 1811226475 | Martha Ann Turner | Social Worker | 5417 31st Ave, Apt 5i, Woodside, NY 11377-1651 | 2009-12-10 |
| 1275761892 | So King Leung | Social Worker | 6002 Queens Blvd Lowr Level, Woodside, NY 11377-4973 | 2009-06-23 |
| Find all providers in WOODSIDE | ||||
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| 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.