MARCUS DEVAUGHN JACKSON (NPI# 1811495138) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811495138 |
| Entity Type | Individual |
| Full Name | MARCUS DEVAUGHN JACKSON |
| Practice Address |
221 Gladys Hodge Rd Homer LA 71040-5447 |
| Practice Telephone | 3182459176 |
| Mailing Telephone | 3182459176 |
| Enumeration Date | 2018-02-01 |
| Last Update Date | 2018-02-01 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336767128 | Marcus S Jackson Sr. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5615 Shell Rd, Pensacola, FL 32503-7825 | 2020-07-08 |
| 1770028425 | Marcus Jackson | Counselor | 2313 Almonaster Ave, New Orleans, LA 70117 | 2017-01-04 |
| 1811044845 | Marcus Jackson | Dentist | 8847 Veterans Memorial Blvd Ste B, Metairie, LA 70003-7707 | 2007-01-04 |
| 1548868946 | Marcus Jackson | Pharmacist | 518 Donelson Pike, Nashville, TN 37214-3729 | 2020-10-16 |
| 1063022499 | Marcus K Jackson | Dentist | 521 E Mountain View Ave, Ellensburg, WA 98926-3865 | 2020-07-31 |
| 1992314595 | Marcus Jackson | Case Manager/Care Coordinator | 2880 Central Pkwy, Cincinnati, OH 45225-2302 | 2020-07-29 |
| 1124523899 | Marcus Dior Jackson | In Home Supportive Care | 1913 Tremont St Se, Washington, DC 20020-7604 | 2018-03-26 |
| 1558863076 | Marcus Joseph Jackson | Behavior Technician | 648 Independence Pkwy Ste 300, Chesapeake, VA 23320-5208 | 2018-02-28 |
| 1568821320 | Marcus Jackson | Case Manager/Care Coordinator | 14785 Preston Rd, Suite 550, Dallas, TX 75254-7876 | 2016-02-22 |
| 1720361652 | Marcus Jackson | Psychologist | 320 Princess Ave, North Las Vegas, NV 89030-3809 | 2011-09-27 |
| Street Address |
221 GLADYS HODGE RD |
| City | HOMER |
| State | LA |
| Zip Code | 71040-5447 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609066646 | Homer Memorial Hospital | Nurse Anesthetist, Certified Registered | 620 East College St., Homer, LA 71040 | 2007-07-26 |
| 1881806164 | Southern Ingenuity Inc | Day Training, Developmentally Disabled Services | 598 Harmon Loop, Homer, LA 71040 | 2007-05-07 |
| 1104048214 | A and L of Northeast La Inc | Day Training, Developmentally Disabled Services | 911 West Main, Homer, LA 71040 | 2007-05-02 |
| 1356409619 | Southern Ingenuity Inc | Day Training, Developmentally Disabled Services | 3250 Hwy 79, Homer, LA 71040 | 2006-12-05 |
| 1851343529 | Claiborne Manor Nursing Home, LLC | Skilled Nursing Facility | 6942 Highway 79 North, Homer, LA 71040 | 2006-05-17 |
| 1679523807 | Larry Don Ezell | Emergency Medicine | 620 Ecollege Street, Homer, LA 71040 | 2006-05-10 |
| 1386856680 | Southern Ingenuity Inc | Day Training, Developmentally Disabled Services | 598 Harmon Loop, Homer, LA 71040 | 2007-05-07 |
| 1720290034 | Southern Ingenuity Inc | Day Training, Developmentally Disabled Services | 598 Harmon Loop, Homer, LA 71040 | 2007-05-07 |
| 1831137579 | Helen Denise Butler | Nurse Practitioner | 104 Morris Cir, Homer, LA 71040 | 2006-06-03 |
| 1245452234 | Melvin Harold Procell | Dentist | 5220 Highway 79, Homer, LA 71040-2002 | 2007-05-02 |
| Find all providers in zip 71040 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528564481 | Kelly Darlene Mayer | Counselor | 6 N West St Ste 5, Homer, NY 13077-1068 | 2018-03-31 |
| 1346741287 | Jennifer K Hultberg Dye | Counselor | 1044 E End Rd Ste C, Homer, AK 99603-7205 | 2018-02-26 |
| 1093214769 | Natasha Jenkins | Counselor | 1204 Pearl St, Homer, LA 71040-4634 | 2018-02-07 |
| 1881193019 | Densesy Lashell Nicholson | Counselor | 347 Sycamore St, Homer, LA 71040-4522 | 2018-02-02 |
| 1285178970 | Leslie Banks | Counselor | 639 W 4th St, Homer, LA 71040-3233 | 2016-12-14 |
| 1578933669 | Diane Dyer | Counselor | 857 Buckner St, Homer, LA 71040-4671 | 2015-10-01 |
| 1689952889 | Alexis Eukisa Slaughter | Counselor | 835 Ford Rd, Homer, LA 71040-5321 | 2011-07-22 |
| 1134395528 | Maria Kaye Calhoun | Counselor | 1044 E End Rd, Suite C, Homer, AK 99603-7205 | 2008-05-05 |
| 1619578440 | Cody Davidson | Counselor | 3948 Ben Walters Ln, Homer, AK 99603-7708 | 2020-11-06 |
| 1104427913 | Holly Bliss | Counselor | 3948 Ben Walters Ln, Homer, AK 99603-7708 | 2020-11-06 |
| Find all providers in HOMER | ||||
Please comment or provide details below to improve the information on MARCUS DEVAUGHN 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.