MS. BEVERLY JACKSON (NPI# 1720008444) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720008444 |
| Entity Type | Individual |
| Full Name | MS. BEVERLY JACKSON |
| Credential | LCPC |
| Practice Address |
210 N Higgins Ave 316 Missoula MT 59802-4462 |
| Mailing Address |
1440 Mountain View Dr Missoula MT 59802-3358 |
| Practice Telephone | 4065421313 |
| Mailing Telephone | 4065496789 |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
625 | MT | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MT | MT STATE LICENSE | 625 | 01 |
| MT | BLUE CROSS | 75135 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134608391 | Beverly J Jackson | Registered Nurse | 817 Briarcreek Dr, Baytown, TX 77521-3473 | 2018-08-08 |
| 1023548591 | Beverly Jackson | Nurse Practitioner | 608 Pine Pass Circle, Mineral Bluff, GA 30559 | 2017-06-15 |
| 1336465913 | Beverly P Jackson | Nutritionist | 19 Silk St, Norwalk, CT 06850-2916 | 2010-04-08 |
| 1891263125 | Beverly Jackson | Speech-Language Pathologist | 4511 Bestor Dr, Rockville, MD 20853-2100 | 2018-11-05 |
| 1154898468 | Beverly Jackson | Case Manager/Care Coordinator | 2017 Hudson Ln, Monroe, LA 71201-5705 | 2018-10-25 |
| 1871902247 | Beverly Jackson | Community Based Residential Treatment Facility, Mental Illness | 1100 W 6th Ave, Gary, IN 46402-1711 | 2014-08-10 |
| 1477814424 | Beverly Yvonne Jackson | Registered Nurse | 4212 N 16th St, Phoenix, AZ 85016-5319 | 2012-06-06 |
| 1891052619 | Beverly L Jackson | Occupational Therapist | 1860 Pennsylvania Ave, Mcdonough, GA 30253-9117 | 2012-04-18 |
| 1245507813 | Beverly High Jackson | Pharmacist | 2950 S Blue Angel Pkwy, Pensacola, FL 32506-6905 | 2011-11-25 |
| 1750606539 | Beverly Anne Jackson | Counselor | 77 Cortland Ave, San Francisco, CA 94110-5435 | 2010-04-05 |
| Street Address |
210 N HIGGINS AVE 316 |
| City | MISSOULA |
| State | MT |
| Zip Code | 59802-4462 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942259106 | Joyce L Hocker | Psychologist | 210 N Higgins Ave, Ste 309, Missoula, MT 59802-4462 | 2006-05-08 |
| 1194067934 | Jennifer B Hudson | Counselor | 210 N Higgins Ave, Suite 320, Missoula, MT 59802-4462 | 2013-03-19 |
| 1275774499 | Kelli Downs Larson | Counselor | 210 N Higgins Ave, Suite 320, Missoula, MT 59802-4462 | 2009-03-18 |
| 1477753366 | Diane V Haddon Pllc | Social Worker | 210 N Higgins Ave, Suite 324, Missoula, MT 59802-4462 | 2007-07-19 |
| 1871706408 | Petra Gerarda De Groot | Counselor | 210 N Higgins Ave, Suite 327, Missoula, MT 59802-4462 | 2007-05-08 |
| 1134348642 | Mary Jo Barrett | Social Worker | 210 N Higgins Ave, Suite 338, Missoula, MT 59802-4462 | 2007-04-24 |
| 1184842635 | Shan Guisinger | Psychologist | 210 N Higgins Ave, Ste 310, Missoula, MT 59802-4462 | 2007-04-22 |
| 1154469419 | Kerry S. Maier | Counselor | 210 N Higgins Ave, Suite 320, Missoula, MT 59802-4462 | 2007-02-01 |
| 1407913148 | Donna M Ridgeway | Counselor | 210 N Higgins Ave, #326, Missoula, MT 59802-4462 | 2007-01-02 |
| 1376588129 | Joyce L Hocker and Assoc PC | Psychologist | 210 N Higgins Ave, 309, Missoula, MT 59802-4462 | 2006-06-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154945921 | Montana Endoscopy Center, Pllc | Clinic/Center | 1930 W Broadway, Ste B, Missoula, MT 59802 | 2020-06-08 |
| 1194364091 | Tommie Lynn Perusich | Nurse Practitioner | 1120 Cedar St., Missoula, MT 59802 | 2019-12-26 |
| 1386122752 | The Hope Health Alliance, Inc. | Case Management | 314 White House Ln, Missoula, MT 59802 | 2018-07-30 |
| 1881181444 | Carol Anne Lesser | Massage Therapist | 1918 Birch St, Missoula, MT 59802 | 2018-04-19 |
| 1528587581 | Missoula Aids Fund, Inc. | Clinic/Center | 1500 W. Broadway Suite A, Missoula, MT 59802 | 2017-09-11 |
| 1942740667 | Gabrielle Shulman | Counselor | 415 N Higgins Ave Ste 14, Missoula, MT 59802 | 2017-02-28 |
| 1053798736 | Endurance Physio | Clinic/Center | 214 E. Main St, Missoula, MT 59802 | 2015-05-01 |
| 1720481971 | Anna Golding | Counselor | 1325 Wyoming Street, Missoula, MONTANA 59802 | 2014-10-02 |
| 1003255803 | Jennifer Dawn Danielson | Speech-Language Pathologist | 2408 Duncan Drive, Missoula, MT 59802 | 2013-06-14 |
| 1437595725 | Partnership Health Center Inc | Clinic/Center | 1150 Sherwood St, Missoula, MT 59802 | 2013-05-14 |
| Find all providers in zip 59802 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811501190 | Sabina Sabyrkulova | Counselor | 313 Sw Higgins Ave, Missoula, MT 59803-1405 | 2020-09-03 |
| 1437712247 | Abrei Cloud Lcsw LLC | Counselor | 111 N Higgins Ave Ste 200-5, Missoula, MT 59802-4437 | 2019-04-17 |
| 1053876912 | Maegan Rides At The Door | Counselor | 4744 Sonoma St, Missoula, MT 59808-9671 | 2019-02-05 |
| 1336649011 | Molly Murphy Counseling | Counselor | 1515 Fairview Ave Ste 240, Missoula, MT 59801-7821 | 2018-02-19 |
| 1508366881 | Kimberly Kay Parrow | Counselor | 401 S 1st St W, Missoula, MT 59801-1850 | 2018-02-13 |
| 1942740667 | Gabrielle Shulman | Counselor | 415 N Higgins Ave Ste 14, Missoula, MT 59802 | 2017-02-28 |
| 1356888069 | Julienne Reid Stickney | Counselor | 410 Expressway Ste C, Missoula, MT 59808-1537 | 2017-01-20 |
| 1558805002 | Dara Kim Newman | Counselor | 510 Arbor Dr, Missoula, MT 59802-3126 | 2016-12-16 |
| 1457806598 | Stephanie Nold | Counselor | 501 Sw Higgins Ave Apt C, Missoula, MT 59803-1451 | 2016-08-18 |
| 1881042190 | Molly Murphy | Counselor | 405 S 1st St W, Missoula, MT 59801-1850 | 2016-05-26 |
| Find all providers in MISSOULA | ||||
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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.