MR. JERRY CAMAL JACKSON (NPI# 1528182102) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528182102 |
| Entity Type | Individual |
| Full Name | MR. JERRY CAMAL JACKSON |
| Credential | BA |
| Practice Address |
1321 S Fayette St Saginaw MI 48602-1447 |
| Mailing Address |
507 E Grove St Sebewaing MI 48759-1649 |
| Practice Telephone | 9897928000 |
| Practice Fax Number | 9897928445 |
| Mailing Telephone | 9898832199 |
| Mailing Fax Number | 9898832199 |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023549805 | Jerry Jackson | Social Worker | 7937 Westmoreland Ave, Parkville, MD 21234-5435 | 2017-03-23 |
| 1154423234 | Jerry S Jackson | Podiatrist | 300 Aztec St, Montezuma, KS 67867 | 2006-09-01 |
| 1386632081 | Jerry D Jackson | Pharmacist | 415 Springwood Dr, Spartanburg, SC 29302-4047 | 2005-10-07 |
| 1265994313 | Jerry Scott Jackson | Hearing Instrument Specialist | 2601 S Ih 35 Ste A300, Round Rock, TX 78664-7358 | 2019-04-05 |
| 1083097901 | Jerry Louis Jackson Jr. | Marriage & Family Therapist | 801 W 70th St, Los Angeles, CA 90044-5218 | 2015-07-09 |
| 1902053549 | Jerry Jackson | Registered Nurse | 1830 Flower St, Bakersfield, CA 93305-4144 | 2008-08-26 |
| 1821261355 | Jerry W Jackson | Pharmacist | 801 Stadium Dr, Suite # 111, Arlington, TX 76011-6254 | 2008-04-04 |
| 1881874584 | Jerry Jay Jackson | Internal Medicine | 3134 Northside Dr, Bldg B, Key West, FL 33040-8004 | 2007-11-09 |
| 1356423594 | Jerry Edwin Jackson Jr. | Counselor | 3963 Market Street, Suite A, Wilmington, NC 28403 | 2006-10-19 |
| 1699887166 | Jerry Michael Jackson | Counselor | 11016 Ne 2nd Pl, Bellevue, WA 98004-5830 | 2006-08-31 |
| Street Address |
1321 S FAYETTE ST |
| City | SAGINAW |
| State | MI |
| Zip Code | 48602-1447 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417023607 | Kairos Healthcare Incorporated | Substance Abuse Rehabilitation Facility | 1321 S Fayette St, Saginaw, MI 48602-1447 | 2006-11-28 |
| 1619518024 | Larry West | Peer Specialist | 1321 S Fayette St, Saginaw, MI 48602-1447 | 2019-10-07 |
| 1669023289 | Jennifer P Burdick | Counselor | 1321 S Fayette St, Saginaw, MI 48602-1447 | 2019-09-25 |
| 1093374951 | Jennifer Hauch | Peer Specialist | 1321 S Fayette St, Saginaw, MI 48602-1447 | 2019-06-13 |
| 1871967745 | Aaron M Steinke | Counselor | 1321 S Fayette St, Saginaw, MI 48602-1447 | 2015-11-16 |
| 1982075545 | Nicole Orosco | Counselor | 1321 S Fayette St, Saginaw, MI 48602-1447 | 2015-10-08 |
| 1932350592 | Tami Marie Kirkendolph | Counselor | 1321 S Fayette St, Saginaw, MI 48602-1447 | 2008-10-01 |
| 1881861045 | Fabian Martin Torres | Counselor | 1321 S Fayette St, Saginaw, MI 48602-1447 | 2008-05-15 |
| 1609092600 | John Patrick Callahan | Counselor | 1321 S Fayette St, Saginaw, MI 48602-1447 | 2007-04-18 |
| 1801920491 | Mallerey L. Michaels | Social Worker | 1321 S Fayette St, Saginaw, MI 48602-1447 | 2007-03-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326665654 | Samuel R Olson | Student in an Organized Health Care Education/Training Program | Covenent Healthcare Cooper, 700 Cooper Avenue, Saginaw, MI 48602 | 2020-07-02 |
| 1871110726 | Quinn Murphy Ameel | Student in an Organized Health Care Education/Training Program | Cmed 1632 Stone St., Saginaw, MI 48602 | 2020-06-26 |
| 1730713322 | Abiola A Alaka | Student in an Organized Health Care Education/Training Program | 314 N Hamilton St, Saginaw, MI 48602 | 2020-02-24 |
| 1598235137 | Summer Dawn Broekhof | Speech-Language Pathologist | 515 N. Michigan, Saginaw, MI 48602 | 2018-11-27 |
| 1811486293 | Barbara Jean Hall | Physical Therapy Assistant | 500 S Hamilton, Saginaw, MI 48602 | 2018-05-01 |
| 1053808519 | Cst Counseling and Transitional Services Inc | Social Worker | 120 N Michigan Ave Ste 207, Saginaw, MI 48602 | 2018-04-19 |
| 1801325246 | Moregan Rose Lamarr | Social Worker | 304 South Niagara St, Saginaw, MI 48602 | 2017-06-08 |
| 1750818449 | Tamera Graham | Nurse Practitioner | 1447 N. Harrison St., Saginaw, MI 48602 | 2017-05-12 |
| 1831622109 | Brooke Vitale | Technician, Other | 1300 N. Michigan, Autism Plus, Saginaw, MI 48602 | 2017-04-04 |
| 1215387576 | Dorthia Eggleston | Specialist | 1203 Gratiot, Saginaw, MI 48602 | 2016-06-17 |
| Find all providers in zip 48602 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669939492 | Tyana Mcdaniel | Counselor | 6140 Hallmark Ct, Saginaw, MI 48603-4860 | 2019-02-28 |
| 1093105157 | Cynthia Moten | Counselor | 128 North Weadock, Saginaw, MI 48607 | 2015-01-28 |
| 1184013682 | Stacye Williams | Counselor | 127 N Warren Ave, Saginaw, MI 48607 | 2015-01-21 |
| 1063839645 | Hilary A Vansickle | Counselor | 3500 S Washington Rd, Saginaw, MI 48601-4958 | 2014-03-21 |
| 1356773634 | Randall E Genow II | Counselor | 5360 Hampton Pl Ste 200, Saginaw, MI 48604-9451 | 2013-08-08 |
| 1144596073 | Sharon Renee' Berkobien | Counselor | 3400 S. Washington, Saginaw, MI 48601 | 2012-03-26 |
| 1679802870 | Deidrea Sanders | Counselor | 2127 Maplewood Ave, Saginaw, MI 48601-3604 | 2009-12-17 |
| 1528230943 | Rosetta Harrell | Counselor | 2220 N Morson St, Saginaw, MI 48602-3457 | 2008-03-26 |
| 1730365602 | Oslin Brummell-presley | Counselor | 1226 S Jefferson Ave, Saginaw, MI 48601-2634 | 2008-01-10 |
| 1548399165 | Shannon Melissa Taylor Bond | Counselor | 508 Shattuck Rd, Saginaw, MI 48604-2329 | 2007-03-02 |
| Find all providers in SAGINAW | ||||
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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.