LISA JACKSON (NPI# 1568748598) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568748598 |
| Entity Type | Individual |
| Full Name | LISA JACKSON |
| Credential | MS, MFT |
| Practice Address |
3900 W Brown Deer Rd Suite 200 Brown Deer WI 53209-1220 |
| Practice Telephone | 4145402170 |
| Mailing Telephone | 4145402170 |
| Enumeration Date | 2011-10-21 |
| Last Update Date | 2014-07-14 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106H00000X | Marriage & Family Therapist | 249-228 | WI | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598300329 | Lisa Ann Jackson | Speech-Language Pathologist | 802 S Yucatan Dr, Tucson, AZ 85710-4933 | 2019-11-15 |
| 1194292441 | Lisa Jackson | Nurse's Aide | 2423 Montana Blue Dr, Spring, TX 77373-7871 | 2018-10-25 |
| 1770027781 | Lisa Jackson | Registered Nurse | 1520 E Calhoun St, Anderson, SC 29621-2210 | 2016-12-09 |
| 1154711166 | Lisa Jackson | Psychologist | 20111 Horace Harding Expy, Oakland Gardens, NY 11364-1639 | 2015-01-28 |
| 1720493224 | Lisa Nicole Jackson | Specialist/Technologist | 3200 Troup Hwy Ste, 120, Tyler, TX 75701 | 2014-06-24 |
| 1831468420 | Lisa Nicole Jackson | Licensed Practical Nurse | 1599 Prospect Pl Apt 1e, Brooklyn, NY 11233-4451 | 2011-12-28 |
| 1992023030 | Lisa Jackson | Massage Therapist | 7200 Sw 8th Ave Apt 9, Gainesville, FL 32607-1883 | 2010-05-13 |
| 1487844973 | Lisa Nicole Jackson | Obstetrics & Gynecology | 89-06 135th St, Room 6a, Jamaica, NY 11418 | 2007-07-31 |
| 1497828826 | Lisa Lanette Jackson | Nurse Practitioner | 1117 Chestnut St, Lewisville, AR 71845 | 2006-11-15 |
| 1972696516 | Lisa Thompson Jackson | Nurse Anesthetist, Certified Registered | 1500 E. Woodrow Wilson, Jackson, MS 39216 | 2006-10-02 |
| Street Address |
3900 W BROWN DEER RD SUITE 200 |
| City | BROWN DEER |
| State | WI |
| Zip Code | 53209-1220 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639188105 | Rosalie Cowdin | Counselor | 3900 W Brown Deer Rd, Suite 200, Brown Deer, WI 53209-1220 | 2006-08-05 |
| 1619592573 | Kayla Moe | Counselor | 3900 W Brown Deer Rd, Brown Deer, WI 53209-1220 | 2020-06-16 |
| 1952839045 | Sarah Charneski | Social Worker | 3900 W Brown Deer Rd, Brown Deer, WI 53209-1220 | 2017-06-01 |
| 1801320585 | Michaela Ramos | Counselor | 3900 W Brown Deer Rd, Suite 200, Brown Deer, WI 53209-1220 | 2017-04-19 |
| 1851832943 | Dentamed Healthcare LLC | Clinic/Center | 3900 W Brown Deer Rd, Suite A, #212, Brown Deer, WI 53209-1220 | 2017-03-09 |
| 1144771403 | Audra Heiking | Marriage & Family Therapist | 3900 W Brown Deer Rd, Suite 200, Brown Deer, WI 53209 | 2016-10-20 |
| 1164973160 | Samantha Pierce | Counselor | 3900 W Brown Deer Rd, Suite 200, Brown Deer, WI 53209-1220 | 2016-10-14 |
| 1154871499 | Marniece Johnson | Counselor | 3900 W Brown Deer Rd, Suite 200, Brown Deer, WI 53209-1220 | 2016-10-11 |
| 1487107215 | Southida Xayachack | Social Worker | 3900 W Brown Deer Rd, Suite 200, Brown Deer, WI 53209-1220 | 2016-07-28 |
| 1922451285 | Jennifer Vann | Counselor | 3900 W Brown Deer Rd, Suite 200, Brown Deer, WI 53209-1220 | 2016-07-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780238253 | Niajcia Brookshire | Counselor | 3900 W Brown Deer Rd Suite 200, Brown Deer, WI 53209 | 2019-08-01 |
| 1740751015 | Mary Fuller | Home Health Aide | 3043 N 29th St., Milwaukee, WI 53209 | 2018-12-16 |
| 1154869410 | Jacksonscott2 | Skilled Nursing Facility | 4573 N. 22nd Street, Milwaukee, WI 53209 | 2017-02-07 |
| 1669910469 | Dimera House | In Home Supportive Care | 4002 W Fairount Ave, Milwaukee, WI 53209 | 2017-02-01 |
| 1891248340 | Amy L May | Nurse Practitioner | 3303 W Good Hope Rd, Milwaukee, WI 53209 | 2016-08-02 |
| 1871980193 | Alan R Rosenthal | Pharmacist | 6930 N Beech Tree Dr, Milwaukee, WI 53209 | 2015-04-24 |
| 1104212380 | Reema Shah | Student in an Organized Health Care Education/Training Program | 2400 W. Villard Ave, Milwaukee, WI 53209 | 2015-04-14 |
| 1336534403 | Robert Michael Kitsis | Family Medicine | 9252 N Green Bay Rd Fl 2, Brown Deer, WI 53209 | 2015-04-05 |
| 1962891994 | Kls Community Outreach Teen Center Consulting and Management L.L.C. | Public Health or Welfare | 8330 North Teutonia Ave Suite 103, Brown Deer, WI 53209 | 2015-01-14 |
| 1548659634 | Kls Community Outreach Teen Center Consulting and Management L.L.C. | Early Intervention Provider Agency | 8330 North Teutonia Avenue Suite 103, Brown Deer, WI 53209 | 2015-01-13 |
| Find all providers in zip 53209 | ||||
| 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 |
|---|---|---|---|---|
| 1497167324 | Alyssa C Vosters | Marriage & Family Therapist | 3900 West Brown Deer Rd, Suite 200, Brown Deer, WI 53209-1220 | 2014-05-27 |
| 1669086930 | Emily Prahlow | Marriage & Family Therapist | 3900 W Brown Deer Rd Ste 200, Brown Deer, WI 53209-1220 | 2020-09-03 |
| 1407403470 | Karynda Dupree | Marriage & Family Therapist | 3900 W Brown Deer Rd Ste 200, Brown Deer, WI 53209-1220 | 2019-08-23 |
| 1881113389 | Katherine Jane Carpenter | Marriage & Family Therapist | 3900 W Brown Deer Rd Ste 200, Brown Deer, WI 53209-1220 | 2017-09-15 |
| 1336663145 | Payton Peterson | Marriage & Family Therapist | 3900 W Brown Deer Rd Ste 200, Brown Deer, WI 53209-1220 | 2017-08-02 |
| 1144771403 | Audra Heiking | Marriage & Family Therapist | 3900 W Brown Deer Rd, Suite 200, Brown Deer, WI 53209 | 2016-10-20 |
| 1255678538 | Stephanie Kuehn | Marriage & Family Therapist | 3900 W Brown Deer Rd, Suite 200, Brown Deer, WI 53209-1220 | 2013-01-07 |
| 1598071631 | Kariann Kay Pajak Bergeron | Marriage & Family Therapist | 3900 W Brown Deer Rd, Suite 200, Brown Deer, WI 53209-1220 | 2010-08-26 |
| 1154656569 | Eleena Hardzinski | Marriage & Family Therapist | 3900 W Brown Deer Rd, Suite 200, Brown Deer, WI 53209-1220 | 2009-10-03 |
| 1063609733 | Renelle E. Nelson | Marriage & Family Therapist | 5600 W Brown Deer Rd, Suite 216, Brown Deer, WI 53223-2311 | 2007-09-26 |
| Find all providers in BROWN DEER | ||||
| City | BROWN DEER |
| Zip Code | 53209 |
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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.