KEVIN THOMAS JACKSON (NPI# 1114456498) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114456498 |
| Entity Type | Individual |
| Full Name | KEVIN THOMAS JACKSON |
| Practice Address |
310 S 49th W Ave Tulsa OK 74127 |
| Mailing Address |
310 S 49th West Ave Tulsa OK 74127-7619 |
| Practice Telephone | 9188139699 |
| Enumeration Date | 2017-06-08 |
| Last Update Date | 2017-06-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164845400 | Kevin Jackson Sr. | Counselor | 621 E Carnagie Dr # 210 San Bernardino Ca 92415, San Bernardino, CA 92415-3919 | 2014-01-22 |
| 1932545449 | Kevin D Jackson | Behavioral Analyst | 4060 Old Plantation Loop, Tallahassee, FL 32311-1306 | 2013-05-13 |
| 1174867634 | Kevin D Jackson | Dentist | 8101 Hinson Farm Rd Ste 216, Alexandria, VA 22306-3406 | 2012-11-21 |
| 1366724270 | Kevin R Jackson | Health Educator | 19752 Snowden St, Detroit, MI 48235-1180 | 2011-09-16 |
| 1376838300 | Kevin Jackson | Counselor | 15108 Doveheart Ln, Bowie, MD 20721-3054 | 2011-06-17 |
| 1881724607 | Kevin Carl Jackson | Optometrist | 7828 Eastern Ave Nw, Washington, DC 20012 | 2007-03-07 |
| 1144291907 | Kevin T Jackson | Family Medicine | 1420 Highway 62 65 N, Harrison, AR 72601-1959 | 2006-01-30 |
| 1316938517 | Kevin Lee Jackson | Internal Medicine | 2430 Village Professional Dr, Opelika, AL 36801-2378 | 2005-11-04 |
| 1588654115 | Kevin Michael Jackson | Optometrist | 39-06 Kramer Pl, Fair Lawn, NJ 07410-5311 | 2005-10-25 |
| 1225032782 | Kevin Gordon Jackson | Family Medicine | 8111 E Thomas Rd, Ste 124, Scottsdale, AZ 85251-5844 | 2005-06-11 |
| Street Address |
310 S 49TH W AVE |
| City | TULSA |
| State | OK |
| Zip Code | 74127 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366966699 | Tarell Lynell Earl | Case Manager/Care Coordinator | 602 N. 28th W. Pl., Tulsa, OK 74127 | 2017-07-28 |
| 1023538014 | Milton Dean IIi | Counselor | 1234 N Rosedale, Tulsa, OK 74127 | 2017-06-21 |
| 1740700988 | Lisa Lee Ann Gilliland | Case Manager/Care Coordinator | 2001 W Ute Pl, Tulsa, OK 74127 | 2017-06-20 |
| 1427406180 | Byron Conrad Dixon Jr. | Case Manager/Care Coordinator | 551 N. 28th W. Ave., Tulsa, OK 74127 | 2016-06-02 |
| 1548621568 | Brandon Worth | Student in an Organized Health Care Education/Training Program | 717 S. Houston Ave., Suite 400, Tulsa, OK 74127 | 2016-03-18 |
| 1073987467 | Jo Lowe | Social Worker | 420 S. Lawton Ave. Apt 315, Tulsa, OK 74127 | 2015-11-23 |
| 1154718575 | William Hughes | Health Educator | 3101 W Edison, Tulsa, OK 74127 | 2015-04-23 |
| 1801289665 | Kristyn Janelle Zrenda | Student in an Organized Health Care Education/Training Program | 717 S. Houston Ave., Suite 400, Tulsa, OK 74127 | 2015-03-17 |
| 1831595719 | Mallory Yarbrough | Counselor | 3005 N 24th West Ave, Tulsa, OK 74127 | 2014-11-05 |
| 1386066272 | Kimberly Lockett | Case Manager/Care Coordinator | 1055 S. Houston West. Ave, Family and Children Services Crisis Center, Tulsa, OK 74127 | 2014-01-10 |
| Find all providers in zip 74127 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881292464 | Sara Saxman | Counselor | 7829 S Yale Ave Apt A, Tulsa, OK 74136-9051 | 2020-10-15 |
| 1881207306 | Jennifer Mcdonald | Counselor | 9804 E 21st Pl Apt A, Tulsa, OK 74129-3815 | 2020-08-25 |
| 1053932905 | Suzanne Schneider | Counselor | 1507 E 21st St, Tulsa, OK 74114-1339 | 2020-05-01 |
| 1396371167 | Amy Lynn Herrold | Counselor | 8211 E Regal Pl, Tulsa, OK 74133-7167 | 2020-03-12 |
| 1033758453 | Anew Dawn Counseling Services LLC | Counselor | 2227 S Garnett Rd Ste 106, Tulsa, OK 74129-5115 | 2020-01-02 |
| 1679111231 | Shandeisha N Hay | Counselor | 6131 S Yorktown Ave Apt 1, Tulsa, OK 74136-0936 | 2019-12-13 |
| 1699320119 | Grace Oluloto | Counselor | 2740 E 41st St N, Tulsa, OK 74110-1432 | 2019-08-02 |
| 1467005900 | Courtney Gillespie | Counselor | 8810 S Yale Ave Ste K, Tulsa, OK 74137-3551 | 2019-07-23 |
| 1922660661 | Katherine Marie Nash | Counselor | 5072 S Toledo Ave Apt 23c, Tulsa, OK 74135-3350 | 2019-07-02 |
| 1205493590 | Wright Choice Counseling Services, LLC | Counselor | 6130 E 32nd St Ste 106, Tulsa, OK 74135-5454 | 2019-05-22 |
| Find all providers in TULSA | ||||
Please comment or provide details below to improve the information on KEVIN THOMAS 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.