MR. DOUGLAS CLARENCE JACKSON (NPI# 1013160316) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013160316 |
| Entity Type | Individual |
| Full Name | MR. DOUGLAS CLARENCE JACKSON |
| Credential | SUBSTANCE COUNSELOR |
| Practice Address |
2384 Atlantic Ave Brooklyn NY 11233-3402 |
| Practice Telephone | 7184950920 |
| Practice Fax Number | 7183455468 |
| Mailing Telephone | 7184950920 |
| Mailing Fax Number | 7183455468 |
| Enumeration Date | 2008-10-30 |
| Last Update Date | 2008-10-30 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730384744 | Douglas Reed Jackson | Neuromusculoskeletal Medicine & OMM | 3211 Applewood Rd, Midland, MI 48640-2666 | 2007-06-19 |
| 1245367655 | Douglas Wayne Jackson | Dentist | 5540 S 79th E Place, Tulsa, OK 74145-7846 | 2007-02-27 |
| 1457401762 | Douglas Jackson | Dentist | 714 E. 4th Ave, Red Springs, NC 28377 | 2007-01-11 |
| 1063432342 | Douglas R Jackson | Family Medicine | 517 W Junipero St Unit 1, 334 S Patterson Ave #120, Santa Barbara, CA 93105-4239 | 2006-07-20 |
| 1760412241 | Douglas Gilbert Jackson I | Nurse Practitioner | 14827 Foothill Rd, Santa Paula, CA 93060-9733 | 2006-07-03 |
| 1962472407 | Douglas T Jackson | Anesthesiology | 150 Bargen St, F 102, Newark, NJ 07103 | 2006-01-26 |
| 1184277857 | Douglas Jackson | Nurse Practitioner | 1100 Reid Pkwy, Richmond, IN 47374-1157 | 2019-07-22 |
| 1427394147 | Douglas Ray Jackson | Pharmacist | 600 Sheldon St, Creston, IA 50801-3322 | 2012-12-27 |
| 1891071635 | Douglas Scott Jackson | Pharmacist | 116 S George St, Suite 101, York, PA 17401-1474 | 2011-10-25 |
| 1912076639 | Douglas L Jackson | Nurse Anesthetist, Certified Registered | 100 Peyton Way, Suite 200, Charleston, WV 25309-8572 | 2006-11-07 |
| Street Address |
2384 ATLANTIC AVE |
| City | BROOKLYN |
| State | NY |
| Zip Code | 11233-3402 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164549812 | Blended Case Management (icl) | Community/Behavioral Health | 2384 Atlantic Ave, Brooklyn, NY 11233-3402 | 2007-03-26 |
| 1982260576 | Amy Monges | Student in an Organized Health Care Education/Training Program | 2384 Atlantic Ave, Brooklyn, NY 11233-3402 | 2019-05-19 |
| 1093296790 | Alexandra Elise Kreitman | Nurse Practitioner | 2384 Atlantic Ave, Brooklyn, NY 11233-3402 | 2018-08-22 |
| 1568942365 | Katherine Mckinstry | Student in an Organized Health Care Education/Training Program | 2384 Atlantic Ave, Brooklyn, NY 11233-3402 | 2018-08-21 |
| 1023598851 | Nadav Kesler | Student in an Organized Health Care Education/Training Program | 2384 Atlantic Ave, Brooklyn, NY 11233-3402 | 2018-08-21 |
| 1518447267 | Vernia Cambridge-morgan | Community Health Worker | 2384 Atlantic Ave, Brooklyn, NY 11233-3402 | 2018-08-21 |
| 1780164434 | Redell Creary | Community Health Worker | 2384 Atlantic Ave, Brooklyn, NY 11233-3402 | 2018-08-21 |
| 1174003339 | Sharayah Sanon | Counselor | 2384 Atlantic Ave, Brooklyn, NY 11233-3402 | 2018-08-17 |
| 1912486853 | Rachel S Salomon | Student in an Organized Health Care Education/Training Program | 2384 Atlantic Ave, Brooklyn, NY 11233-3402 | 2018-08-11 |
| 1831678283 | Emily D'angelo | Student in an Organized Health Care Education/Training Program | 2384 Atlantic Ave, Brooklyn, NY 11233-3402 | 2018-08-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467066381 | Elisa Jeanne Smith | Social Worker | 1505 St. Marks Ave, Clinical Office, Brooklyn, NY 11233 | 2020-09-08 |
| 1154968493 | Jahmani Hylton | Social Worker | 451 Macon Street, Ground Floor, Brooklyn, NY 11233 | 2019-12-05 |
| 1487121935 | Kimberly Ramsay | Social Worker | 1847 Prospect Place, Basement, Brooklyn, NY 11233 | 2018-11-01 |
| 1952823874 | Valerie A Davis | Specialist | 1769 Park Place, 1a, Brooklyn, NY 11233 | 2017-07-12 |
| 1053833988 | Griselda Colmena | Case Manager/Care Coordinator | 1765 Prospect Pl, 2h, Brooklyn, NY 11233 | 2017-07-12 |
| 1316476724 | Juliana Susannah Green Peters | Registered Nurse | 887 Hancock St, Brooklyn, NY 11233 | 2017-06-08 |
| 1043744816 | Marjorie Direny | Social Worker | 23484 Atlantic Ave, Brooklyn, NY 11233 | 2017-04-18 |
| 1467999169 | Myint M Nwe | Student in an Organized Health Care Education/Training Program | #30 Kane Place, Brooklyn, New York City, NY 11233 | 2017-01-20 |
| 1053857417 | Lateefat Lawal | Case Manager/Care Coordinator | 216 Rockaway Ave, Apt 22a, Brooklyn, NY 11233 | 2017-01-10 |
| 1932659232 | Tonetta Arnold | Counselor | 1569 Prospect, 6b, Brooklyn, NY 11233 | 2016-10-11 |
| Find all providers in zip 11233 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225639099 | Munisa Mukhamatkulova | Specialist | 1133 E 73rd St, Brooklyn, NY 11234-5409 | 2020-11-06 |
| 1699376251 | Ilona Gamer | Specialist | 2525 E 23rd St, Brooklyn, NY 11235-2505 | 2020-11-02 |
| 1043818545 | Doris Gonzalez-rivera | Specialist | 5610 Avenue T, Brooklyn, NY 11234-4724 | 2020-10-15 |
| 1023625936 | Chaya R Zaetz | Specialist | 797 Maple St, Brooklyn, NY 11203-1312 | 2020-09-24 |
| 1801402060 | Discover Licensed Behavior Analyst Pllc | Specialist | 1350 55th St, Brooklyn, NY 11219-4213 | 2020-09-22 |
| 1114533320 | Yocheved Gershonowitz | Specialist | 1694 E 7th St, Brooklyn, NY 11223-2216 | 2020-09-22 |
| 1992311260 | Sherry A Valentine | Specialist | 1937 Bay Ridge Ave Apt 3r, Brooklyn, NY 11204-4546 | 2020-09-21 |
| 1609481670 | Celina Stolpen | Specialist | 2527 E 27th St, Brooklyn, NY 11235-2016 | 2020-09-15 |
| 1386259760 | Elina Khamish | Specialist | 155 Oceana Dr E Apt 3g, Brooklyn, NY 11235-6684 | 2020-09-11 |
| 1053925263 | Michelle Shneyder | Specialist | 2111 Voorhies Ave, Brooklyn, NY 11235-2817 | 2020-09-04 |
| Find all providers in BROOKLYN | ||||
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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.