ALBERT JACKSON (NPI# 1720421795) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720421795 |
| Entity Type | Individual |
| Full Name | ALBERT JACKSON |
| Credential | AODA |
| Practice Address |
4001 W Capitol Dr Milwaukee WI 53216-2530 |
| Mailing Address |
4950 N 21st Street Milwaukee WI 53209-5750 |
| Practice Telephone | 4148106691 |
| Mailing Telephone | 4143011163 |
| Enumeration Date | 2013-04-09 |
| Last Update Date | 2013-04-09 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
16862-130 | WI | Ambulatory Health Care Facilities |
| Y | 251S00000X | Community/Behavioral Health | 16862-130 | WI | Agencies |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417168667 | Albert Jerome Jackson Jr. | Anesthesiology | 2710 Saint Francis Dr, Ste 410, Waterloo, IA 50702-5619 | 2007-05-26 |
| 1780714063 | Albert Jackson | Social Worker | 165 Quincy St, Brockton, MA 02302-2988 | 2007-03-06 |
| Street Address |
4001 W CAPITOL DR |
| City | MILWAUKEE |
| State | WI |
| Zip Code | 53216-2530 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528274404 | Shakina D Robinson | Counselor | 4001 W Capitol Dr, Milwaukee, WI 53216-2530 | 2007-05-15 |
| 1750904637 | Chauntel Webb | Counselor | 4001 W Capitol Dr, Milwaukee, WI 53216-2530 | 2020-05-26 |
| 1124640891 | Brittany Mahlberg | Counselor | 4001 W Capitol Dr, Milwaukee, WI 53216-2530 | 2020-05-15 |
| 1568083665 | Caroline J Atterberry | Counselor | 4001 W Capitol Dr, Milwaukee, WI 53216-2530 | 2020-04-29 |
| 1043839517 | Yamsine Morton | Counselor | 4001 W Capitol Dr, Milwaukee, WI 53216-2530 | 2020-04-14 |
| 1902431935 | Shannon Emmanuel Johnson | Counselor | 4001 W Capitol Dr, Milwaukee, WI 53216-2530 | 2020-03-10 |
| 1578106084 | Nilufer Karul | Social Worker | 4001 W Capitol Dr, Milwaukee, WI 53216-2530 | 2019-10-28 |
| 1699335778 | Jenna Wahl | Counselor | 4001 W Capitol Dr, Milwaukee, WI 53216-2530 | 2019-06-19 |
| 1811459910 | Mary Kathleen Mann | Counselor | 4001 W Capitol Dr, Milwaukee, WI 53216-2530 | 2019-04-05 |
| 1780146472 | Keegan Patrick Murphy | Marriage & Family Therapist | 4001 W Capitol Dr, Milwaukee, WI 53216-2530 | 2019-04-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750906137 | Lilshana Woods | Technician | 3946 N 52nd St, Milwaukee, WI 53216 | 2020-06-11 |
| 1063981710 | Jon Maurice Smoots | Prevention Professional | 7710 W. Casper Street, Milwaukee, WI 53216 | 2018-11-23 |
| 1467948844 | Alexcis Coleman | Counselor | 6815 W Capitol Dr Ste 217, Milwaukee, WI 53216 | 2018-07-09 |
| 1457841066 | Rebeka Fried | Occupational Therapist | 3134 N 53rd St, Milwaukee, WI 53216 | 2018-05-18 |
| 1952831497 | Nina Marie Evans | Home Health Aide | 6815 W. Capitol Drive Suite 117, Milwaukee, WI 53216 | 2017-06-18 |
| 1578009080 | Annette L Veasey | Counselor | 4222 W Capitol Dr Ste 308, Milwaukee, WI 53216 | 2017-01-09 |
| 1295277143 | Gentle Hands Home Healthcare | Home Health | 6815 N. 68th Street, Milwaukee, WI 53216 | 2016-11-09 |
| 1639622780 | Luisa Julia Morales | Counselor | 5228 Fond Du Lac Ave, Milwaukee, WI 53216 | 2016-07-25 |
| 1568811776 | Eye-care Home Health Care | In Home Supportive Care | 6221 W Keefe Pkwy, Milwaukee, WI 53216 | 2016-06-08 |
| 1013382167 | Helens Supportive Services | Home Health | 6222 W Capitol Drive Sutie 200c, Milwaukee, WI 53216 | 2015-12-01 |
| Find all providers in zip 53216 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558968990 | Zoran Jovicic | Community/Behavioral Health | 3239 S 58th St Unit 104, Milwaukee, WI 53219-4365 | 2020-10-08 |
| 1548816580 | Latara Williams | Community/Behavioral Health | 2447 N 50th St, Milwaukee, WI 53210-2815 | 2019-08-15 |
| 1942856091 | Kennedy's Circle of Wellness LLC | Community/Behavioral Health | 3614 W North Ave, Milwaukee, WI 53208-1416 | 2019-08-14 |
| 1205391828 | Jerome Pitchford | Community/Behavioral Health | 1220 W Atkinson Ave, Milwaukee, WI 53206-3024 | 2019-02-07 |
| 1194233718 | The Evolving Chair Counseling and Consulting Agency | Community/Behavioral Health | 3100 N 78th St, Milwaukee, WI 53222-3916 | 2018-01-17 |
| 1316453905 | D.a.a.n.i Professional Counseling Service LLC | Community/Behavioral Health | 2943 N 52nd St, Milwaukee, WI 53210-1610 | 2017-12-19 |
| 1932654845 | The Thresholds | Community/Behavioral Health | 6815 W Capitol Dr # 305, Milwaukee, WI 53216-2070 | 2016-08-20 |
| 1801341144 | Fly Philanthropy Inc | Community/Behavioral Health | 3352 N Palmer St, Milwaukee, WI 53212-1541 | 2016-08-16 |
| 1659726545 | Pathway Youth & Famiy Services | Community/Behavioral Health | 3879 N Port Washington Rd, Milwaukee, WI 53212-1180 | 2016-04-27 |
| 1528413671 | Adventures In Play, LLC | Community/Behavioral Health | 2118 E Kenilworth Pl, Lowr, Milwaukee, WI 53202-1327 | 2016-04-26 |
| Find all providers in MILWAUKEE | ||||
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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.