NICOLE L JACKSON (NPI# 1053745521) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053745521 |
| Entity Type | Individual |
| Full Name | NICOLE L JACKSON |
| Credential | LPC |
| Practice Address |
3394 Mckelvey Rd Ste 116 Bridgeton MO 63044-2531 |
| Mailing Address |
501 Lynn Haven Ln Hazelwood MO 63042-1809 |
| Practice Telephone | 3146566153 |
| Mailing Telephone | 3146078653 |
| Enumeration Date | 2013-09-02 |
| Last Update Date | 2020-05-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
2013023409 | MO | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 490048738 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1633 Hudson Rd, Saint Louis, MO 631362313 | 3147203024 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699184689 | Nicole Jackson | Specialist | 3983 Thunder Heights Ln, Middleburg, FL 32068-7362 | 2014-08-05 |
| 1245569276 | Nicole Denise Jackson | Licensed Practical Nurse | 2122 Ridge Rd W, Rochester, NY 14626-2802 | 2009-12-22 |
| 1144559931 | Nicole L Jackson | Licensed Practical Nurse | 18680 Main Street, Tontogany, OH 43565 | 2009-12-08 |
| 1144489261 | Nicole L. Jackson | Counselor | 6815 W Capitol Dr Ste 304, Milwaukee, WI 53216-2056 | 2008-06-04 |
| 1124299680 | Nicole Jackson | Licensed Practical Nurse | 1830 Southern Pkwy, Springfield, OH 45506-3115 | 2008-03-12 |
| 1578740023 | Nicole Jackson | Counselor | 3630 George Washington Hwy, Ste B-6, Yorktown, VA 23693 | 2008-01-28 |
| 1205999588 | Nicole Lewis Jackson | Dentist | 3298 Northside Dr, Macon, GA 31210 | 2006-12-18 |
| 1104447275 | Nicole Feliz Jackson | Specialist/Technologist | 1301 S Us Highway 377, Argyle, TX 76226-7744 | 2020-04-30 |
| 1023637220 | Nicole Jackson | Student in an Organized Health Care Education/Training Program | 100 Woods Rd, Valhalla, NY 10595-1530 | 2020-04-09 |
| 1609405539 | Nicole Yvonne Jackson | Licensed Practical Nurse | 15 Frederick Ave, Akron, OH 44310-2904 | 2020-04-03 |
| Street Address |
3394 MCKELVEY RD STE 116 |
| City | BRIDGETON |
| State | MO |
| Zip Code | 63044-2531 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639700024 | Nlj Counseling and Coaching Services, LLC | Counselor | 3394 Mckelvey Rd Ste 116, Bridgeton, MO 63044-2531 | 2020-02-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073150017 | Zoe Marie Wadsworth | Nurse Practitioner | 12255 Depaul Dr Suite 300, Bridgeton, MO 63044 | 2019-12-10 |
| 1609412451 | Beyond Better, Best Home Health Care Services, Limited Liability Corpo | In Home Supportive Care | 3430 Mckelvey Road Ste B, Bridgeton, MO 63044 | 2019-11-26 |
| 1275189078 | Delicate Angels Home Health LLC | Home Health | 11726 St. Charles Rock Road Suite G, Bridgeton, MO 63044 | 2019-08-16 |
| 1588210082 | Nicholas Huber | Physical Therapist | 12349 Depaul Dr., Ste. 110, Bridgeton, MO 63044 | 2019-08-12 |
| 1124688858 | Michelle Bassett | Registered Nurse | 11520 St. Charles Rock Rd., Suite 106, Bridgeton, MO 63044 | 2019-06-14 |
| 1336703883 | Elena A Barrow | Nurse Practitioner | 12255 Depaul Dr, Suite 260, Bridgeton, MO 63044 | 2019-04-30 |
| 1487123105 | Laura N Steiner | Registered Nurse | Gateway Pediatrics, Ltd, 12255 Depaul Drive, Suite 460 North Medical Building, Bridgeton, MO 63044 | 2018-11-26 |
| 1205310950 | Danielle Mathis | Nurse Practitioner | 3440 Depaul Lane Suite 201, Bridgeton, MO 63044 | 2018-09-19 |
| 1588163570 | Thoughts Out Loud Counseling, LLC | Social Worker | 11520 St. Charles Rock Road Suite 101, Bridgeton, MO 63044 | 2018-02-06 |
| 1912411430 | Breanna Victoria Hayes | Counselor | 3165 Mckevley Road, Suite 200, Bridgeton, MO 63044 | 2017-11-20 |
| Find all providers in zip 63044 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811555782 | Cecilia Dominique Carter | Counselor | 3751 Pennridge Dr Ste 113, Bridgeton, MO 63044-1244 | 2019-06-05 |
| 1578126132 | Jazell Dailey Thomas | Counselor | 11520 Saint Charles Rock Rd Ste 103, Bridgeton, MO 63044-2732 | 2019-04-19 |
| 1841799459 | Robin S Moore-chambers | Counselor | 11520 Saint Charles Rock Rd Ste 215, Bridgeton, MO 63044-2732 | 2018-02-09 |
| 1487180048 | Stacy Rowlett | Counselor | 3548 Yellow Jasmine Dr, Bridgeton, MO 63044-3192 | 2017-05-02 |
| 1770028193 | Emily Mcleod | Counselor | 12301 Depaul Dr., Bridgeton, MO 63044 | 2016-12-20 |
| 1568870335 | Danielle White | Counselor | 3435 Bridgeland Dr, Suite B, Bridgeton, MO 63044-2638 | 2014-07-24 |
| 1679750798 | Kandy M Smith | Counselor | 3751 Pennridge Dr Ste 119, Bridgeton, MO 63044-1244 | 2008-01-31 |
| 1255462586 | Deborah Kay Peters | Counselor | 11300 Saint Charles Rock Rd, Bridgeton, MO 63044-2721 | 2007-03-08 |
| 1275132771 | Amber Wilson | Counselor | 3751 Pennridge Dr Ste 119, Bridgeton, MO 63044-1244 | 2020-10-26 |
| 1639700024 | Nlj Counseling and Coaching Services, LLC | Counselor | 3394 Mckelvey Rd Ste 116, Bridgeton, MO 63044-2531 | 2020-02-04 |
| Find all providers in BRIDGETON | ||||
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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.