MS. MARY Y JACKSON (NPI# 1629109665) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629109665 |
| Entity Type | Individual |
| Full Name | MS. MARY Y JACKSON |
| Credential | LCSW |
| Practice Address |
1804 Martin Luther King Jr. Parkway Suite 210 Durham NC 27707-2933 |
| Mailing Address |
16 Burgess Ln Durham NC 27707-2933 |
| Practice Telephone | 9194892254 |
| Practice Fax Number | 9194031551 |
| Mailing Telephone | 9194933888 |
| Enumeration Date | 2007-03-09 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
C001005 | NC | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 6106541 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922605690 | Mary Sonya Jackson | Contractor | 5480 Hedge Brooke Pointe Nw, Acworth, GA 30101-7142 | 2020-10-06 |
| 1194388678 | Mary Sheree Jackson | Home Health Aide | 226 Mckinley St, Pittsburgh, PA 15210-3312 | 2019-04-19 |
| 1508358813 | Mary Jackson | Counselor | 3442 W Emma Pl, Queen Creek, AZ 85142-0506 | 2018-06-01 |
| 1891220935 | Mary Jackson | Counselor | 2824 N Cascade Ave, Colorado Springs, CO 80907-6213 | 2017-04-26 |
| 1992152672 | Mary Jackson | Non-emergency Medical Transport (VAN) | 421 Lively Hope Rd, Callao, VA 22435-2511 | 2016-05-23 |
| 1699121129 | Mary Theresa Jackson | Counselor | 345 Old Cuyler Rd, Ellabell, GA 31308-5858 | 2016-05-13 |
| 1013331586 | Mary Jackson I | Chore Provider | 555 Old Lewiston Rd, Winthrop, ME 04364-4112 | 2014-02-04 |
| 1316203854 | Mary Louise Jackson | Home Health Aide | 256 Clairmont Ave, Mansfield, OH 44903-1547 | 2012-04-10 |
| 1376835298 | Mary Bickel Jackson | Nutritionist | 33 Fulton Plaza, Middletown, NY 10940 | 2011-05-11 |
| 1437456522 | Mary Elisabeth Jackson | Counselor | 804 South Oakland Ave, Carbondale, IN 62901 | 2011-02-25 |
| Street Address |
1804 MARTIN LUTHER KING JR. PARKWAY SUITE 210 |
| City | DURHAM |
| State | NC |
| Zip Code | 27707-2933 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396965299 | Delice Coffey | Psychologist | 1804 Martin Luther King Jr. Parkway, Durham, NC 27707 | 2007-04-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538785928 | Ceara Smith | Social Worker | 1415 W Nc 54 Buidling 200, Suite 111, Durham, NC 27707 | 2020-06-22 |
| 1114554094 | Lauren Michelle Grosse | Physician Assistant | Fastmed Urgent Care 7010 Nc-751, Durham, NC 27707 | 2020-03-23 |
| 1386289635 | Ashley Bailey | Counselor | 1801 Fayetteville Street, Durham, NC 27707 | 2019-11-11 |
| 1881249886 | Erin Ramona Leger | Physical Therapist | 3706 Mayfair St, Ste 120, Durham, NC 27707 | 2019-08-06 |
| 1417417262 | Carmen Elisabeth Sanchez | Psychologist | 3326 Durham Chapel Hill Blvd Bldg D, Durham, NC 27707 | 2019-03-20 |
| 1477026144 | Pope Behavioral Health and Wellness | Counselor | 5102 Chapel Hill Durham Blvd., Suite 101, Durham, NC 27707 | 2019-01-06 |
| 1043780778 | Jessica Ann Revels | Counselor | 1415 West North Carolina 54, Building 100 Suite # 204, Durham, NC 27707 | 2018-11-26 |
| 1558830125 | Michael Brown | Counselor | 1502 W Nc-54, Suite 505, Durham, NC 27707 | 2018-11-13 |
| 1780152827 | Cassandra Gerwig Shaw | Registered Nurse | 5324 Mcfarland Dr Ste 310, Durham, NC 27707 | 2018-11-07 |
| 1942776232 | Lisa J Keskitalo | Physical Therapist | 3708 Mayfair St Ste 120, Durham, NC 27707 | 2018-10-15 |
| Find all providers in zip 27707 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326652710 | Myracle Clay Clay-bennett | Counselor | 2933 S Miami Blvd, Durham, NC 27703-8025 | 2020-09-02 |
| 1376160218 | Compass Family Therapy, Pllc | Counselor | 3326 Guess Rd Ste 207, Durham, NC 27705-2160 | 2020-06-26 |
| 1144857665 | Jennifer Saucier Simmons | Counselor | 212 Maiden Ln, Durham, CT 06422-2017 | 2020-03-25 |
| 1902457328 | Natalie Haskins Parmenter | Counselor | 5825 Sandstone Dr, Durham, NC 27713-1925 | 2019-09-26 |
| 1043780778 | Jessica Ann Revels | Counselor | 1415 West North Carolina 54, Building 100 Suite # 204, Durham, NC 27707 | 2018-11-26 |
| 1558830125 | Michael Brown | Counselor | 1502 W Nc-54, Suite 505, Durham, NC 27707 | 2018-11-13 |
| 1205314390 | Ashley Danielle Gilmore | Counselor | 48 Intuition Cir, Durham, NC 27705-2881 | 2018-08-01 |
| 1477060606 | Benjamin Christian Willcott | Counselor | 2612 N Roxboro St, Durham, NC 27704-4350 | 2018-01-09 |
| 1851842694 | Bull City Psychotherapy, Pllc | Counselor | 1816 Front St Ste 250, Durham, NC 27705-2598 | 2016-10-17 |
| 1730632506 | Selena Waite | Counselor | 2309 Nebo St, Durham, NC 27707-4231 | 2016-07-28 |
| Find all providers in DURHAM | ||||
Please comment or provide details below to improve the information on MS. MARY Y 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.