MS. DIANA SUE JACKSON (NPI# 1902352412) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902352412 |
| Entity Type | Individual |
| Full Name | MS. DIANA SUE JACKSON |
| Credential | LMHC, CADC |
| Practice Address |
1744 2nd Ave Se Cedar Rapids IA 52403-2306 |
| Mailing Address |
4101 Hickory Hill Ln Cedar Rapids IA 52403-3740 |
| Practice Telephone | 3193664673 |
| Mailing Telephone | 3192133775 |
| Enumeration Date | 2016-08-25 |
| Last Update Date | 2019-05-01 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
14116 | IA | Behavioral Health & Social Service Providers |
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
079713 | IA | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255787594 | Diana Yashieka Jackson | Licensed Practical Nurse | 973 Portland Ave, Downstairs, Rochester, NY 14621-4165 | 2016-05-05 |
| 1225449499 | Diana Jackson | Licensed Practical Nurse | 5582a Zapata Dr, Pegram, TN 37143-2300 | 2014-05-09 |
| 1962631424 | Diana Jackson | Licensed Practical Nurse | 6628 Crescent Grn, West Bloomfield, MI 48322-1325 | 2009-07-06 |
| 1225247752 | Diana Dean Jackson | Specialist | 6133 Elm Ln, Matteson, IL 60443-1321 | 2007-05-22 |
| 1902405004 | Diana Lynn Jackson | Technician | 409 Spring Ave, Moorefield, WV 26836-1036 | 2020-10-20 |
| 1417498007 | Diana Jackson | Nurse Practitioner | 300 Main St, Lewiston, ME 04240-7027 | 2017-03-15 |
| 1417378787 | Diana Beltran Jackson | Speech-Language Pathologist | 3355 Boca Chica Blvd, Suite 8, Brownsville, TX 78521-4201 | 2014-01-03 |
| 1942423959 | Diana Jackson | Counselor | 19 E 6th St, Tracy, CA 95376-4107 | 2007-04-10 |
| 1083837843 | Diana Marie Jackson | Nurse Practitioner | 1025 Pennock Pl, Fort Collins, CO 80524-3257 | 2007-04-10 |
| Street Address |
1744 2ND AVE SE |
| City | CEDAR RAPIDS |
| State | IA |
| Zip Code | 52403-2306 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801292883 | Laura Pelechek | Marriage & Family Therapist | 1744 2nd Ave Se, Cedar Rapids, IA 52403 | 2014-11-18 |
| 1255847711 | Beverly Catherine Pospisil | Marriage & Family Therapist | 1744 2nd Ave Se, Cedar Rapids, IA 52403-2306 | 2017-12-20 |
| 1326564527 | House of Hope | Clinic/Center | 1744 2nd Ave Se, Cedar Rapids, IA 52403-2306 | 2017-08-18 |
| 1609248848 | Nikita Ehlts | Counselor | 1744 2nd Ave Se, Cedar Rapids, IA 52403-2306 | 2015-10-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093242083 | Eric Burton | Social Worker | 1535 1st Ave Se., Cedar Rapids Va Cboc, Cedar Rapids, IA 52403 | 2017-05-22 |
| 1619404613 | Dylan Roberts Streb | Family Medicine | Eastern Iowa Health Center, 1201 Third Avenue Se, Cedar Rapids, IA 52403 | 2017-05-22 |
| 1760870851 | Forefront Dermatology, S.c. | Dermatology | 202 10th Street, Sw, Suite 290, Cedar Rapids, IA 52403 | 2014-12-26 |
| 1306090147 | John Daniel Schuchmann | Anesthesiology | 3629 Random Road Se, Cedar Rapids, IA 52403 | 2008-11-06 |
| 1851564157 | Cedar Rapids Medical Education Foundation | Family Medicine | 1260 Second Avenue S.e., Cedar Rapids, IA 52403 | 2008-04-08 |
| 1093866071 | Mcld Corporation | Durable Medical Equipment & Medical Supplies | 207 2nd Avenue Se Ste A, Cedar Rapids, IA 52403 | 2007-01-16 |
| 1154483980 | James P Schuller | Dentist | 1000 42nd St Se, 1000 Professional Centre Suite B, Cedar Rapids, IA 52403 | 2006-12-15 |
| 1477640183 | C R Iv Service Inc | Home Health | 402 10th St, Ste 700 Carepro Home Health, Cedar Rapids, IA 52403 | 2006-10-06 |
| 1104919638 | C R Iv Service Inc | Durable Medical Equipment & Medical Supplies | 402 10th Street Se, Suite 700, Cedar Rapids, IA 52403 | 2006-10-02 |
| 1699880138 | Affiliates of Family Practice of Cedar Rapids | Family Medicine | 1030 5th Avenue Se, Suite 1700, Cedar Rapids, IA 52403 | 2006-08-21 |
| Find all providers in zip 52403 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013523943 | Bryan Busch | Counselor | 1030 5th Ave Se # Ate3000, Cedar Rapids, IA 52403-2464 | 2020-09-16 |
| 1477179133 | James L Neubauer | Counselor | 3745 Center Point Rd Ne, Cedar Rapids, IA 52402-2926 | 2020-06-18 |
| 1366065062 | Thea Bedell, Lmhc, LLC | Counselor | 3412 Center Point Rd Ne, Cedar Rapids, IA 52402-5529 | 2020-05-28 |
| 1629609037 | Alyssa Anne Mcdowell | Counselor | 1073 Rockford Rd Sw Ste E, Cedar Rapids, IA 52404-1868 | 2020-02-04 |
| 1316589682 | Gail Wood | Counselor | 1660 42nd St Ne Ste O, Cedar Rapids, IA 52402-3066 | 2019-10-08 |
| 1154962991 | Tracy Adam | Counselor | 1221 Park Pl Ne Ste F, Cedar Rapids, IA 52402-2019 | 2019-10-02 |
| 1144883539 | Barbara Lynn Murphy | Counselor | 3635 Bever Ave Se, Cedar Rapids, IA 52403-4330 | 2019-04-21 |
| 1700358520 | Syndrea Porter | Counselor | 1146 Blairs Ferry Rd Ne Ste 2, Cedar Rapids, IA 52402-1274 | 2018-12-18 |
| 1144791153 | Shannon Elise Perea | Counselor | 215 4th Ave Se, Cedar Rapids, IA 52401-1844 | 2018-12-17 |
| 1902375801 | A New Leaf Mental Health & Wellness Center, Inc | Counselor | 5925 Council St Ne Ste 117, Cedar Rapids, IA 52402-5860 | 2018-11-20 |
| Find all providers in CEDAR RAPIDS | ||||
| City | CEDAR RAPIDS |
| Zip Code | 52403 |
Please comment or provide details below to improve the information on MS. DIANA SUE 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.