UNDRA JACKSON


Address: 1701 White St, Mccomb, MS 39648-2711
Phone: 6012494218

UNDRA JACKSON (NPI# 1083196851) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1083196851
Entity Type Individual
Full Name UNDRA JACKSON
Practice Address 1701 White St
Mccomb
MS 39648-2711
Practice Telephone 6012494218
Practice Fax Number 6012494234
Mailing Telephone 6012494218
Mailing Fax Number 6012494234
Enumeration Date 2018-08-29
Last Update Date 2018-08-29
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 101YS0200X Counselor
Specialization: School
Behavioral Health & Social Service Providers

Office Location

Street Address 1701 WHITE ST
City MCCOMB
State MS
Zip Code 39648-2711

Providers in the same location

NPI Name Taxonomy Address Enumeration
1932159423 Jody Mcintyre Marriage & Family Therapist 1701 White St, Mccomb, MS 39648-2711 2006-05-12
1376144519 Tameka Pinder Registered Nurse 1701 White St, Mccomb, MS 39648-2711 2020-11-04
1225637002 Ariel Coleman Counselor 1701 White St, Mccomb, MS 39648-2711 2020-10-22
1821695313 Sherrie Short Counselor 1701 White St, Mccomb, MS 39648-2711 2020-10-07
1013524396 Catina Brigss Counselor 1701 White St, Mccomb, MS 39648-2711 2020-09-30
1114533288 Lasontiga Forrest Registered Nurse 1701 White St, Mccomb, MS 39648-2711 2020-09-23
1831707439 Vanessa L Gardner Counselor 1701 White St, Mccomb, MS 39648-2711 2020-07-20
1366069080 Ramonda Copeland Counselor 1701 White St, Mccomb, MS 39648-2711 2020-06-29
1154947018 Kimberly Hurst Counselor 1701 White St, Mccomb, MS 39648-2711 2020-06-17
1770104598 Hanna Moak Counselor 1701 White St, Mccomb, MS 39648-2711 2020-05-04
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1952910366 Ct Stamps Inc Pharmacy 206 Marion Avenue, Mccomb, MS 39648 2020-07-31
1952910457 Fresenius Medical Care East Mccomb Dialysis, LLC Clinic/Center 103 Business Center Drive, Mccomb, MS 39648 2020-07-30
1902423312 Joseph Edward Mingo II Counselor 513 Lee St, Mccomb, MS 39648 2020-07-01
1427608769 Benda Truvillion Technician 2128 Park Dr. Ext., Mccomb, MS 39648 2019-09-18
1295228187 Edna Ruth Winston Counselor Sw Ms Mental Health Complex, 1701 White St, Mccomb, MS 39648 2018-06-14
1386153450 Sholitha Nunnery Counselor 502 North Cherry Street, Mccomb, MS 39648 2017-09-21
1548600612 Jordan Harrington Nurse Practitioner 303 Marion Ave., Mccomb, MS 39648 2013-07-03
1891096236 Zwound Care Family Medicine 1126 Country Club Road, Mccomb, MS 39648 2010-11-16
1588891717 Kelly Edmondson Physical Therapy Assistant 1301a Harrison Ave, Mccomb, MS 39648 2009-06-15
1962647651 Gwendolyn Michelle Brown Home Health Aide 1114 1/2 Venable St., Mccomb, MS 39648 2008-12-09
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Taxonomy Information

Taxonomy Code 101YS0200X
Grouping Behavioral Health & Social Service Providers
Classification Counselor
Specialization School

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1053959874 Leotyne Anderson Counselor 124 Major Cir, Saltillo, MS 38866-8109 2019-12-11
1649742933 Karen Patricia Noone-yvon Counselor 711 N Union St, Natchez, MS 39120-2950 2018-12-26
1265724504 Building Bridges Association Counselor 4925 Poplar Springs Dr, Meridian, MS 39305-1618 2011-05-04
1740881911 Creations of Care Home Health Care Ll. Counselor 1520 29th Ave Ste 8, Gulfport, MS 39501-2843 2020-11-04
1578055489 Gwendolyn Earlene Shaw Counselor 152 Highway 7 S, Oxford, MS 38655 2018-06-06
1134677008 Bridget Charese Lesure Counselor 152 Highway 7 S, Oxford, MS 38655-5392 2016-09-20
1801341979 Paul Dean Ross Counselor 152 Highway 7 S, Oxford, MS 38655-5392 2016-08-18
1063816981 Raneshia N Lee Counselor 2725 Highway 51 S, Hernando, MS 38632-2634 2014-10-21
1053733261 Kimberly Jean Stevenson Counselor 152 Highway 7 S, Oxford, MS 38655-5392 2014-01-08
1316287360 Constance N Powell Counselor 152 Highway 7 S, Oxford, MS 38655-5392 2013-02-27
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Competitor

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City MCCOMB
Zip Code 39648

Improve Information

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Dataset Information

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.

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