LISA LYNNETTE JACKSON (NPI# 1891225397) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891225397 |
| Entity Type | Individual |
| Full Name | LISA LYNNETTE JACKSON |
| Credential | LLPC |
| Practice Address |
751 E Grand Blvd Detroit MI 48207-2529 |
| Practice Telephone | 3139222222 |
| Mailing Telephone | 3139222222 |
| Enumeration Date | 2017-06-16 |
| Last Update Date | 2017-06-16 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YM0800X |
Counselor Specialization: Mental Health |
6401016062 | MI | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598300329 | Lisa Ann Jackson | Speech-Language Pathologist | 802 S Yucatan Dr, Tucson, AZ 85710-4933 | 2019-11-15 |
| 1194292441 | Lisa Jackson | Nurse's Aide | 2423 Montana Blue Dr, Spring, TX 77373-7871 | 2018-10-25 |
| 1770027781 | Lisa Jackson | Registered Nurse | 1520 E Calhoun St, Anderson, SC 29621-2210 | 2016-12-09 |
| 1154711166 | Lisa Jackson | Psychologist | 20111 Horace Harding Expy, Oakland Gardens, NY 11364-1639 | 2015-01-28 |
| 1720493224 | Lisa Nicole Jackson | Specialist/Technologist | 3200 Troup Hwy Ste, 120, Tyler, TX 75701 | 2014-06-24 |
| 1831468420 | Lisa Nicole Jackson | Licensed Practical Nurse | 1599 Prospect Pl Apt 1e, Brooklyn, NY 11233-4451 | 2011-12-28 |
| 1992023030 | Lisa Jackson | Massage Therapist | 7200 Sw 8th Ave Apt 9, Gainesville, FL 32607-1883 | 2010-05-13 |
| 1487844973 | Lisa Nicole Jackson | Obstetrics & Gynecology | 89-06 135th St, Room 6a, Jamaica, NY 11418 | 2007-07-31 |
| 1497828826 | Lisa Lanette Jackson | Nurse Practitioner | 1117 Chestnut St, Lewisville, AR 71845 | 2006-11-15 |
| 1972696516 | Lisa Thompson Jackson | Nurse Anesthetist, Certified Registered | 1500 E. Woodrow Wilson, Jackson, MS 39216 | 2006-10-02 |
| Street Address |
751 E GRAND BLVD |
| City | DETROIT |
| State | MI |
| Zip Code | 48207-2529 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700984341 | Quality Behavorial Health Inc. | Substance Abuse Rehabilitation Facility | 751 E Grand Blvd, Detroit, MI 48207-2529 | 2006-09-20 |
| 1609407311 | Marissa Osinski | Peer Specialist | 751 E Grand Blvd, Detroit, MI 48207-2529 | 2020-01-31 |
| 1821560145 | Sheniva Sanders | Social Worker | 751 E Grand Blvd, Detroit, MI 48207-2529 | 2018-12-27 |
| 1578068896 | Channell Loraine Johnson | Counselor | 751 E Grand Blvd, Detroit, MI 48207-2529 | 2018-03-28 |
| 1770081242 | Joya Monnett Loray Nunn | Counselor | 751 E Grand Blvd, Detroit, MI 48207-2529 | 2018-01-30 |
| 1699283234 | Karen Stanford | Registered Nurse | 751 E Grand Blvd, Detroit, MI 48207-2529 | 2018-01-17 |
| 1730697830 | Jamie Wood | Registered Nurse | 751 E Grand Blvd, Detroit, MI 48207-2529 | 2018-01-11 |
| 1790292670 | Beverly Bunton | Licensed Practical Nurse | 751 E Grand Blvd, Detroit, MI 48207-2529 | 2018-01-02 |
| 1427564921 | Christina Byrd | Licensed Practical Nurse | 751 E Grand Blvd, Detroit, MI 48207-2529 | 2017-12-19 |
| 1407371529 | Kymaletha Rochelle Brown | Counselor | 751 E Grand Blvd, Detroit, MI 48207-2529 | 2017-08-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245848506 | Anton R Gonzales | Physical Therapy Assistant | 2295 Chene, Detroit, Mi 48207, Detroit, MI 48207 | 2020-07-22 |
| 1033733928 | Taleshia Moss | Occupational Therapist | 2295 Chene, Detroit, MI 48207 | 2020-06-05 |
| 1942858550 | Ronald Royce Cochran | Counselor | 2925 Russell St, Detroit, Detroit, MI 48207 | 2019-08-27 |
| 1649831439 | Charday Penick | Social Worker | Team Wellness, 2925 Russell St, Detroit, MI 48207 | 2019-06-24 |
| 1568023349 | Alphia Ramona Burgess | Social Worker | Team Wellness Center, 2925 Russell Street, Detroit, MI 48207 | 2019-06-24 |
| 1447741608 | Sherice Ward | Social Worker | 100 River Place Drive, Ste 250, Detroit, MI 48207 | 2018-05-23 |
| 1427549955 | Mission Point of Detroit, LLC | Skilled Nursing Facility | 2102 Orleans, Detroit, MI 48207 | 2018-05-21 |
| 1043723737 | Olivia Carter | Case Management | 2712 Gratiot, Detroit, MI 48207 | 2017-11-16 |
| 1558885590 | Kalimah Johnson | Social Worker | 701 Mcdougall, Detroit, MI 48207 | 2017-08-01 |
| 1922534692 | Angela Young | Social Worker | 100 River Place 520, Detroit, MI 48207 | 2017-05-02 |
| Find all providers in zip 48207 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407457799 | Next Level Counseling and Consulting, LLC | Counselor | 5231 Grayton St, Detroit, MI 48224-2149 | 2020-11-04 |
| 1669071585 | Carraus Harden | Counselor | 13238 N Norfolk, Detroit, MI 48235-1026 | 2020-10-21 |
| 1386255032 | Restore Me, LLC | Counselor | 17836 Chandler Park Dr, Detroit, MI 48224-1340 | 2020-08-14 |
| 1396374617 | Venus D Amos | Counselor | 22725 Cambridge Ave, Detroit, MI 48219-1725 | 2020-04-07 |
| 1487280848 | A Safe Place Counseling and Community Support Services L3c | Counselor | 20216 Albany St, Detroit, MI 48234-2505 | 2020-03-18 |
| 1689211088 | Tracey Johnson | Counselor | 14010 Monica St Apt 23, Detroit, MI 48238-2565 | 2019-12-04 |
| 1790320331 | Faith Hope & Love Outreach Center Inc | Counselor | 18284 James Couzens Fwy., Detroit, MI 48235-2503 | 2019-11-07 |
| 1518517606 | Southwest Solutions | Counselor | 5716 Michigan, Detroit, MI 48210 | 2019-09-19 |
| 1942858550 | Ronald Royce Cochran | Counselor | 2925 Russell St, Detroit, Detroit, MI 48207 | 2019-08-27 |
| 1497210744 | Phoenix Interventions Pllc | Counselor | 7633 E Jefferson Ave Ste 110, Detroit, MI 48214-3730 | 2019-01-31 |
| Find all providers in DETROIT | ||||
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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.