LINDA TERESA JACKOSN (NPI# 1770927386) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770927386 |
| Entity Type | Individual |
| Full Name | LINDA TERESA JACKOSN |
| Practice Address |
675 N Matthews Rd Lake City SC 29560-7027 |
| Practice Telephone | 8433947600 |
| Mailing Telephone | 8433947600 |
| Enumeration Date | 2013-04-25 |
| Last Update Date | 2013-04-25 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | 376421 | 05 | |
| SC | MEDICARE | 3337 | 01 |
| Street Address |
675 N MATTHEWS RD |
| City | LAKE CITY |
| State | SC |
| Zip Code | 29560-7027 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861525669 | Lavon Tosha Cain | Counselor | 675 N Matthews Rd, Lake City, SC 29560-7027 | 2007-03-13 |
| 1285147124 | Latoria Blake | Counselor | 675 N Matthews Rd, Lake City, SC 29560-7027 | 2017-11-14 |
| 1457703332 | Jameel Pearson | Community/Behavioral Health | 675 N Matthews Rd, Lake City, SC 29560-7027 | 2016-07-05 |
| 1730585779 | Regina Knight | Counselor | 675 N Matthews Rd, Lake City, SC 29560-7027 | 2014-11-18 |
| 1043636046 | Pee Dee Mental Health | Clinic/Center | 675 N Matthews Rd, Lake City, SC 29560-7027 | 2014-03-14 |
| 1699894113 | Harriet Annette Rose | Counselor | 675 N Matthews Rd, Lake City, SC 29560-7027 | 2007-03-28 |
| 1942328471 | Gordon P. Mackenzie | Counselor | 675 N Matthews Rd, Lake City, SC 29560-7027 | 2007-03-26 |
| 1174641666 | Pee Dee Mental Health Center | Community/Behavioral Health | 675 N Matthews Rd, Lake City, SC 29560-7027 | 2007-03-26 |
| 1578689303 | Tiffaney Medina Brown | Counselor | 675 N Matthews Rd, Lake City, SC 29560-7027 | 2007-03-22 |
| 1598881302 | Lavelle Weaver | Registered Nurse | 675 N Matthews Rd, Lake City, SC 29560-7027 | 2007-03-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457830366 | Patty Fulmore | In Home Supportive Care | 141 Bulldog Lane, Lake City, SC 29560 | 2018-08-10 |
| 1558875211 | Msk Transportation | Non-emergency Medical Transport (VAN) | 226 Lake Dale Ave, Lake City, SC 29560 | 2017-11-16 |
| 1861867566 | Denita Alison Pleasant | Pharmacist | 301 West Thomas Street, Lake City, SC 29560 | 2015-12-07 |
| 1821474115 | Pro-motion Physical Therapy of Florence, Sc, LLC | Occupational Therapist | 148 B Sauls Street, Lake City, SC 29560 | 2015-08-10 |
| 1023412335 | Motivations-unlimited | Speech-Language Pathologist | 318 A Moore Street, Lake City, SC 29560 | 2014-10-15 |
| 1700297652 | Sharon Lewis | Pharmacist | 900 Us Highway 52, Lake City, SC 29560 | 2014-05-14 |
| 1376954305 | Sergio Montes | Pharmacist | 900 Us Hwy 52, Lake City, SC 29560 | 2014-05-13 |
| 1992122857 | Paula Moses | Pharmacist | 900 U.s Hwy. 52, Lake City, SC 29560 | 2014-03-27 |
| 1063762763 | Dawn Mcelveen Floyd | Pharmacist | 301 W Thomas Street, Lake City, SC 29560 | 2012-09-11 |
| 1548519507 | Robert Bruce Page | Pharmacist | 401 West Thomas St, Lake City, SC 29560 | 2012-09-06 |
| Find all providers in zip 29560 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992303846 | Colette L Bone | Counselor | 919 Godfrey Rd, Lake City, PA 16423-2110 | 2020-10-13 |
| 1487203956 | Amber Renee Granger Baughman | Counselor | 691 Nw Jean Ct, Lake City, FL 32055-7062 | 2019-09-08 |
| 1649730219 | Ricketta Tiara Arline | Counselor | 260 S Marion Ave Ste 105, Lake City, FL 32025-7034 | 2019-03-21 |
| 1154716447 | Lindsey Morton | Counselor | 219 Se Baya Avenue, Lake City, FL 32055 | 2015-04-02 |
| 1861886277 | Resolutions Health Alliance, P | Counselor | 1344 Se Baya Dr, Lake City, FL 32025-4888 | 2015-03-24 |
| 1881012292 | Rachel Christian Parker | Counselor | 3546 Sw State Road 247, Lake City, FL 32024-0785 | 2014-04-02 |
| 1801213871 | Gina Stork | Counselor | 3662 Garber Ave, Lake City, IA 51449-7554 | 2014-03-27 |
| 1578990784 | North Florida Center for Counseling, LLC | Counselor | 260 South Marion Avenue Suite 140, Lake City, FL 32025 | 2013-10-02 |
| 1184924649 | Stephanie Dayle Douglas | Counselor | 197 Sw Sarah Ct, Lake City, FL 32024-3852 | 2010-10-29 |
| 1326278433 | Lydia Dryer Marohn | Counselor | 356 S Marion Ave, Lake City, FL 32025-5261 | 2009-07-23 |
| Find all providers in LAKE CITY | ||||
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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.