SKYLETTE V JACKSON (NPI# 1639667611) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639667611 |
| Entity Type | Individual |
| Full Name | SKYLETTE V JACKSON |
| Credential | MS, CAADC |
| Practice Address |
28879 Hudson Corner Rd Marion MD 21838-2105 |
| Practice Telephone | 4436140829 |
| Mailing Telephone | 4436140829 |
| Enumeration Date | 2018-04-25 |
| Last Update Date | 2018-04-25 |
| Gender Code | F |
| 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 |
| Street Address |
28879 HUDSON CORNER RD |
| City | MARION |
| State | MD |
| Zip Code | 21838-2105 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598815656 | Annette J. Banatte-victor | Nurse Practitioner | 5892 Crisfield Highway, 5892 Crisfield Highway, Marion, MD 21838-0156 | 2007-01-11 |
| 1164607743 | Shore Staffing, Inc. | Nursing Care | 3109 Fair Island Ln, Marion Station, MD 21838-2461 | 2008-01-02 |
| 1518224609 | Somerset Communit Services | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 5574 Tulls Corner Rd, Marion, MD 21838-2521 | 2012-04-13 |
| 1891742532 | Edward H Klopp Md Pa | Surgery | 27496 Coulbourne Creek Road, Marion Station, MD 21838-2800 | 2006-05-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356942320 | Freda Cunningham | Pharmacy | 2100 Hwy 77, Marion, AR 72364 | 2020-11-05 |
| 1730780214 | Rhonda Leigh Herrmann | Pharmacist | 13969 Moore Rd, Marion, IL 62959-6835 | 2020-11-03 |
| 1669073219 | Kelsey Castek | Physical Therapist | 905 29th Ave Ste 140, Marion, IA 52302-1138 | 2020-11-02 |
| 1790385375 | David Lee Rosenbaum | Driver | 127 Hemlock St, Marion, VA 24354-4403 | 2020-10-31 |
| 1245830942 | Jim Robert Lysne | Non-emergency Medical Transport (VAN) | 3032 14th Ave, Marion, IA 52302-1524 | 2020-10-30 |
| 1417556929 | Julia Zane Carter | Occupational Therapist | 198 Military Rd, Marion, AR 72364-1703 | 2020-10-26 |
| 1407455025 | Iowa Careway Transit LLC | Non-emergency Medical Transport (VAN) | 1250 Country Club Dr, Marion, IA 52302-5504 | 2020-10-23 |
| 1386243020 | Select Physical Therapy Holdings, Inc. | Clinic/Center | 2500 Williamson County Pkwy, Suite B, Marion, IL 62959-5271 | 2020-10-23 |
| 1306445309 | Teresa Nicole Worthy | Counselor | 6690 Rose Ln # B, Marion, MS 39342-9201 | 2020-10-21 |
| 1104425347 | Sophoni Ndahiyimbaze Darius | Non-emergency Medical Transport (VAN) | 1475 Blackhawk Dr, Marion, IA 52302-6713 | 2020-10-20 |
| Find all providers in MARION | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073121778 | Ashley Jade Kirby | Counselor | 1581 Marion Waldo Rd # 710, Marion, OH 43302-7423 | 2020-07-20 |
| 1104452333 | Patrick Travis Woodruff | Counselor | 246a S Main St, Marion, NC 28752-4551 | 2020-03-19 |
| 1982245874 | John Robert Searfoss Sr. | Counselor | 314 S Norton Ave., Marion, IN 46952 | 2019-10-02 |
| 1508411026 | Tristan Wayne Killian | Counselor | 356 Beaver Creek Rd, Marion, NC 28752-9081 | 2019-08-02 |
| 1487214854 | Jennifer Marie Kositzky | Counselor | 151 Marion Blvd, Marion, IA 52302-3135 | 2019-06-18 |
| 1548767767 | Johnnie Micheal Hiles | Counselor | 315 South Norton Ave., Marion, IN 46952 | 2018-04-13 |
| 1023515392 | Robbie S Mccain-ficklin | Counselor | 315 S Norton St, Marion, IN 46952-3296 | 2018-04-12 |
| 1669979936 | Sheila Ann Johnson | Counselor | 315 S. Norton Ave, Marion, IN 46952 | 2018-04-12 |
| 1679070957 | Marissa Lynn Castillo | Counselor | 315 S Norton Avenue, Marion, IN 46952 | 2018-04-12 |
| 1407371909 | Davet Mcfadden | Counselor | 103 Court Street, Marion, SC 29571 | 2017-08-07 |
| Find all providers in MARION | ||||
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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.