DR. JEFFREY BROWN JACKSON (NPI# 1447481205) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447481205 |
| Entity Type | Individual |
| Full Name | DR. JEFFREY BROWN JACKSON |
| Credential | PH.D., LMFT |
| Practice Address |
450 N University Ave Suite 204 Provo UT 84601-2860 |
| Mailing Address |
1372 N 1230 W Orem UT 84057-6512 |
| Practice Telephone | 8018158105 |
| Mailing Telephone | 8018158105 |
| Enumeration Date | 2009-07-28 |
| Last Update Date | 2009-07-28 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106H00000X | Marriage & Family Therapist | 5731350-3902 | UT | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578193181 | Jeffrey Jackson | Student in an Organized Health Care Education/Training Program | 1055 W Longfellow Dr, Manteno, IL 60950-9472 | 2020-01-22 |
| 1881259570 | Jeffrey Lamar Jackson II | Chiropractor | 13865 S Dixie Hwy # 307, Miami, FL 33176-7221 | 2019-05-08 |
| 1548753965 | Jeffrey Jackson | Social Worker | 2024 Corporate Centre Dr Ste 103, Myrtle Beach, SC 29577-7410 | 2018-06-11 |
| 1154792422 | Jeffrey Scott Jackson | Occupational Therapy Assistant | 3209 Bristol Hwy., Nhc Healthcare, Johnson City, TN 37601 | 2015-10-13 |
| 1952421927 | Jeffrey W Jackson | Pharmacist | 5510 Lafayette Rd Ste 260, Indianapolis, IN 46254-1691 | 2007-03-30 |
| 1659432607 | Jeffrey L Jackson | Internal Medicine | 500o W National Ave, Milwaukee, WI 53295-0001 | 2006-12-13 |
| 1760589477 | Jeffrey Scott Jackson | Pharmacist | 16821 Rosman Hwy, Lake Toxaway, NC 28747-9593 | 2006-09-17 |
| 1194764860 | Jeffrey Kline Jackson | Family Medicine | 2200 W Touhy Ave, Chicago, IL 60645-3412 | 2006-06-06 |
| 1972563443 | Jeffrey A Jackson | Internal Medicine | 720 Eskenzi Ave., Indianapolis, IN 46202-5166 | 2006-03-27 |
| 1033759154 | Jeffrey Frank Jackson | Nurse Anesthetist, Certified Registered | 2142 N Cove Blvd, Toledo, OH 43606-3895 | 2020-01-07 |
| Street Address |
450 N UNIVERSITY AVE SUITE 204 |
| City | PROVO |
| State | UT |
| Zip Code | 84601-2860 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356688527 | Lisa R. Owens | Massage Therapist | 450 N University Ave, Suite 206, Provo, UT 84601-2860 | 2013-01-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902378417 | 1 Assist Care of Utah Valley LLC | In Home Supportive Care | 180 N University Avenue, Suite 270, Office 213, Provo, UT 84601 | 2018-12-21 |
| 1346723319 | Mp Dental LLC | Dentist | 777 N. 500 W. #204, Proud, UT 84601 | 2018-09-14 |
| 1326530601 | Madison Paige Nelson | Case Manager/Care Coordinator | 750 N Freedom Blvd., Provo, UT 84601 | 2018-06-03 |
| 1245758861 | Annette Roylance | Case Manager/Care Coordinator | 750 North Freedom Boulevard, Suite 300, Provo, UT 84601 | 2017-09-04 |
| 1912422205 | Alexandra Mcbride | Specialist/Technologist | 35 N 300 W #440, Provo, UT 84601 | 2017-08-07 |
| 1932638293 | Audrey Clara Clifton | Case Manager/Care Coordinator | 750 North Freedom Blvd., Provo, UT 84601 | 2017-06-08 |
| 1528514197 | Joseph Hyrum Lewis | Case Manager/Care Coordinator | 750 Freedom Blvd, Provo, UT 84601 | 2016-09-01 |
| 1629427620 | Walker Clements | Case Manager/Care Coordinator | 750 North Freedom Blvd, Provo, UT 84601 | 2016-06-09 |
| 1447611595 | Robert Shirley | Student in an Organized Health Care Education/Training Program | 750 North 200 West, Provo, Ut 84601., Provo, UT 84601 | 2016-03-17 |
| 1700286283 | Brelynn Downs | Student in an Organized Health Care Education/Training Program | 750 North Freedom Blvde, Provo, UT 84601 | 2014-09-03 |
| Find all providers in zip 84601 | ||||
| Taxonomy Code | 106H00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Marriage & Family Therapist |
| A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861996621 | Angeline Lloyd | Marriage & Family Therapist | 1675 N Freedom Blvd Ste 5b, Provo, UT 84604-2555 | 2018-03-19 |
| 1518407964 | Flourish Counseling Services Pllc | Marriage & Family Therapist | 91 W 200 S, Provo, UT 84601-4443 | 2017-03-05 |
| 1285189514 | Daniel Allen Burgess | Marriage & Family Therapist | 4665 Mile High Dr, Provo, UT 84604-6311 | 2016-08-16 |
| 1235519067 | Erin Rackham | Marriage & Family Therapist | 3507 N University Ave Ste 350, Provo, UT 84604-6602 | 2015-06-06 |
| 1265811368 | Joanna Sumsion | Marriage & Family Therapist | 4626 N 300 W, Provo, UT 84604-7763 | 2015-05-21 |
| 1982026829 | Emily Freeze | Marriage & Family Therapist | 1881 N 1120 W, Provo, UT 84604 | 2014-01-13 |
| 1356778377 | Myrna Suzanne Gillis | Marriage & Family Therapist | 1726 Buckley Drive, Provo, UT 84606 | 2013-10-04 |
| 1255696423 | Marni K Winkel-reeve | Marriage & Family Therapist | 37 E Center St, Suite #208, Provo, UT 84606-3156 | 2012-07-12 |
| 1033421847 | Mark J Mauzy | Marriage & Family Therapist | 755 S 400 W, Provo, UT 84601-5855 | 2010-07-09 |
| 1588984835 | Ty R. Mansfield | Marriage & Family Therapist | 667 N 1890 W, Provo, UT 84601-1326 | 2010-06-09 |
| Find all providers in PROVO | ||||
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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.