CORRYN HELEN JACKSON (NPI# 1841802469) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841802469 |
| Entity Type | Individual |
| Full Name | CORRYN HELEN JACKSON |
| Credential | LLPC |
| Practice Address |
19855 Outer Dr Ste 300 Dearborn MI 48124-2022 |
| Mailing Address |
21707 Powers Ave Dearborn Heights MI 48125-2657 |
| Practice Telephone | 3133591977 |
| Mailing Telephone | 7346783097 |
| Enumeration Date | 2020-08-17 |
| Last Update Date | 2020-08-17 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
6401016806 | MI | Behavioral Health & Social Service Providers |
| Street Address |
19855 OUTER DR STE 300 |
| City | DEARBORN |
| State | MI |
| Zip Code | 48124-2022 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538784012 | Bethany S Gourley | Psychologist | 19855 Outer Dr Ste 300, Dearborn, MI 48124-2022 | 2020-06-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396389524 | Pharma A, LLC | Pharmacy | 23916 Michigan Ave, Dearborn, MI 48124 | 2019-10-31 |
| 1225683725 | Aysha Said | Behavior Technician | 1369 Porter St, Dearborn, MI 48124 | 2019-08-02 |
| 1881257772 | Leen Nusairat | Internal Medicine | Beaumont Health-dearborn Campus, 18101 Oakwood Blvd, Dearborn, MI 48124 | 2019-04-17 |
| 1417413360 | Gary C. Veraghen, Dds, PC | Dentist | 22100 W. Outer Drive, Dearborn, MI 48124 | 2019-02-15 |
| 1982168787 | Fnu Asma Manzar | Physical Therapist | Global Physical Therapy Services, Inc, 22819 Michigan Avenue, Dearborn, MI 48124 | 2019-01-25 |
| 1639640162 | Jernia Lashawn Usher | Behavior Technician | 1360 Porter St Lower Level, Dearborn, MI 48124 | 2018-12-10 |
| 1710456470 | Samar Fouad Hannawi | Psychologist | 3815 Pelham Street, Suite #13, Dearborn, MI 48124 | 2018-11-24 |
| 1881178747 | Sarah Chehab | Psychologist | 835 Mason St Suite 220b, Dearborn, MI 48124 | 2018-09-17 |
| 1568948289 | Ibrahim M Basma | Pharmacist | 22521 Michigan Avenue, Dearborn, MI 48124 | 2018-07-16 |
| 1669961942 | Jacqueline E Domzalski | Technician, Other | 3231 S. Gulley, Suite E, Dearborn, MI 48124 | 2018-05-02 |
| Find all providers in zip 48124 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073974234 | Bryan Granger | Counselor | 5500 Auto Club Dr Ste 350, Dearborn, MI 48126-2779 | 2016-03-16 |
| 1952730624 | Sanaa Nadim Haidar | Counselor | 835 Mason St, Dearborn, MI 48124-2231 | 2013-11-04 |
| 1346418944 | Bernadine Geraldine Mistor | Counselor | 7466 Calhoun St, Dearborn, MI 48126-1433 | 2008-02-15 |
| 1528240280 | Damita Jo Harris | Counselor | 1800 Grindley Park St, Suite 1, Dearborn, MI 48124-2553 | 2007-12-04 |
| 1194324186 | I.m.a.g.e. Counseling Services | Counselor | 22190 Garrison St Ste 204, Dearborn, MI 48124-2235 | 2020-10-20 |
| 1689280182 | Tori Andrews | Counselor | 835 Mason St Ste B220, Dearborn, MI 48124-2262 | 2020-09-20 |
| 1295340362 | Lina Bazzi | Counselor | 835 Mason St Ste B220, Dearborn, MI 48124-2262 | 2020-09-15 |
| 1114551033 | Paige Kristine Rutkowski | Counselor | 22190 Garrison St Ste 204, Dearborn, MI 48124-2235 | 2020-02-29 |
| 1043795628 | Lisa Michelle Green | Counselor | 835 Mason St Ste B220, Dearborn, MI 48124-2262 | 2018-09-28 |
| 1578047734 | John Glen Flood I | Counselor | 835 Mason St Ste B220, Dearborn, MI 48124-2262 | 2018-09-23 |
| Find all providers in DEARBORN | ||||
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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.