MONIQUE JACKSON (NPI# 1114579208) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114579208 |
| Entity Type | Individual |
| Full Name | MONIQUE JACKSON |
| Credential | LLPC |
| Practice Address |
4410 W 13 Mile Rd Royal Oak MI 48073-6515 |
| Mailing Address |
31600 Schoenherr Rd Apt 12 Warren MI 48088-1919 |
| Practice Telephone | 2485546414 |
| Mailing Telephone | 3137217474 |
| Enumeration Date | 2019-07-10 |
| Last Update Date | 2019-07-10 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | 6401017459 | MI | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871049684 | Monique Jackson | Occupational Therapist | 21630 Jessel Ave, Detroit, MI 48219 | 2016-08-31 |
| 1891178281 | Monique Jackson | Optometrist | 4205 Canal St, Ste B, New Orleans, LA 70119-5942 | 2015-07-02 |
| 1083973697 | Monique Lasean Jackson | Case Manager/Care Coordinator | 2910 Buford Dr, Apt# 702, Buford, GA 30519-5109 | 2012-05-16 |
| 1295026946 | Monique Jackson | Pharmacist | 1728 S Madison St, Whiteville, NC 28472-4934 | 2011-04-28 |
| 1295951291 | Monique Rochell Jackson | Nursing Care | 121 Oregon Ave, Ewing, NJ 08638 | 2007-04-18 |
| 1952338543 | Monique Rachelle Jackson | Nurse Practitioner | 1120 W. Washington Blvd., Los Angeles, CA 90015 | 2006-06-27 |
| 1811482235 | Monique Jackson | Registered Nurse | 89 Bartlett St, Brooklyn, NY 11206-4463 | 2018-06-27 |
| 1427594092 | Monique Jackson | Social Worker | 9701 Philadelphia Ct Ste R, Lanham, MD 20706-4435 | 2017-01-06 |
| 1730622150 | Monique Kimberly Jackson | Social Worker | 8 Atwood Dr, Suite 301, Northampton, MA 01060-4266 | 2016-12-02 |
| 1609224062 | Monique Jackson | Home Health Aide | 1416 9th St Nw, Washington, DC 20001-3344 | 2016-05-26 |
| Street Address |
4410 W 13 MILE RD |
| City | ROYAL OAK |
| State | MI |
| Zip Code | 48073-6515 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033264890 | Judson Center, Inc. | Case Management | 4410 W 13 Mile Rd, Royal Oak, MI 48073-6515 | 2007-01-24 |
| 1861036188 | Amanda Lynn Zeffero | Behavior Technician | 4410 W 13 Mile Rd, Royal Oak, MI 48073-6515 | 2019-10-30 |
| 1821649799 | Jennifer Lynn Radowick | Behavior Technician | 4410 W 13 Mile Rd, Royal Oak, MI 48073-6515 | 2019-09-23 |
| 1053960039 | Chrishara Shanae Richardson | Behavior Technician | 4410 W 13 Mile Rd, Royal Oak, MI 48073-6515 | 2019-09-11 |
| 1154970531 | Olesia Kellezi | Behavior Technician | 4410 W 13 Mile Rd, Royal Oak, MI 48073-6515 | 2019-09-09 |
| 1760036164 | Jacquelyn Paige Renard | Behavior Technician | 4410 W 13 Mile Rd, Royal Oak, MI 48073-6515 | 2019-07-25 |
| 1497308092 | Lauren Macleod | Behavior Technician | 4410 W 13 Mile Rd, Royal Oak, MI 48073-6515 | 2019-07-23 |
| 1073165387 | Rebecca Wilson | Behavior Technician | 4410 W 13 Mile Rd, Royal Oak, MI 48073-6515 | 2019-07-16 |
| 1487211488 | Stephanie Page Ender | Behavior Technician | 4410 W 13 Mile Rd, Royal Oak, MI 48073-6515 | 2019-05-24 |
| 1649735903 | Dana Marie Milliman | Behavior Technician | 4410 W 13 Mile Rd, Royal Oak, MI 48073-6515 | 2019-01-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891306114 | Spine and Joint Surgical Institute of Michigan, LLC | Clinic/Center | 5140 Coolidge Hwy, Ste 200, Royal Oak, MI 48073 | 2020-08-11 |
| 1528679081 | Activo Physical Therapy, LLC | Clinic/Center | 5140 Coolidge Hwy, Ste 101, Royal Oak, MI 48073 | 2020-08-10 |
| 1265057624 | Olga Romina Gomez Rojas | Internal Medicine | 3607 W 13 Mile Rd, Royal Oak, MI 48073 | 2020-06-11 |
| 1598389785 | Devika Aggarwal | Internal Medicine | 3601 W 13 Mile Road Beaumont Hospital- Royal Oak, Royal Oak, MI 48073 | 2020-06-03 |
| 1831713064 | Michael Morelli | Physical Medicine & Rehabilitation | Department of Physical Medicine and Rehabilitation, 3601 W 13 Mile Road, Royal Oak, MI 48073 | 2020-06-03 |
| 1134741895 | Kamil Sardarli | Internal Medicine | Beaumont Hospital - Royal Oak 3601 W Thirteen Mile Road, Royal Oak, MI 48073 | 2020-05-15 |
| 1245850171 | Dema Fawaz | Emergency Medicine | Beaumont Hospital, Royal Oak, Gme Office, 3601 W. 13 Mile Rd, Royal Oak, MI 48073 | 2020-04-21 |
| 1235771049 | Semaan Dentistry Pllc | Dentist | 30955 Woodward Ave Ste 105, Royal Oak, MI 48073 | 2019-10-14 |
| 1013560473 | Muhammad Waqas | Pediatrics | Beaumont Hospital Royal Oak, 3601 W 13 Mile Rd, Royal Oak, MI 48073 | 2019-07-24 |
| 1346804135 | Matthew M Astolfi | Orthopaedic Surgery | 3601 W Thirteenth Mile Road, Royal Oak, MI 48073 | 2019-04-26 |
| Find all providers in zip 48073 | ||||
| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700494721 | Living Water Forever, Pllc | Counselor | 1710 E 12 Mile Rd Ste 101, Royal Oak, MI 48073-4200 | 2020-07-15 |
| 1255958450 | Andrea Sandles | Counselor | 1500 N Stephenson Hwy Ste 240, Royal Oak, MI 48067-1584 | 2020-07-03 |
| 1861025249 | Erica Renee Carulli | Counselor | 1923 Ardmore Ave, Royal Oak, MI 48073-4179 | 2020-02-13 |
| 1003344565 | Alison Christine Maples | Counselor | 3315 N Campbell Rd Ste 200, Royal Oak, MI 48073-2803 | 2017-05-30 |
| 1770919359 | Jennifer Lauren Hurley | Counselor | 824 W 13 Mile Rd, Royal Oak, MI 48073-2463 | 2013-09-16 |
| 1740408244 | Ascension Eastwood Behavioral Health | Counselor | 30701 Woodward Avenue, Suite 200, Royal Oak, MI 48073-0987 | 2007-04-23 |
| 1972135549 | Elisabeth Lauren Rzepkowski | Counselor | 1424 E 11 Mile Rd, Royal Oak, MI 48067-2026 | 2020-02-11 |
| 1003469644 | Latasha J Spencer | Counselor | 30701 Woodward Ave Ste 200, Royal Oak, MI 48073-0990 | 2019-07-23 |
| 1811456734 | Brenda Basel Brikho | Counselor | 30701 Woodward Ave, Royal Oak, MI 48073-0987 | 2019-03-19 |
| 1285125823 | Maples Creative Counseling LLC | Counselor | 3315 N Campbell Rd Ste 200, Royal Oak, MI 48073-2803 | 2018-05-18 |
| Find all providers in ROYAL OAK | ||||
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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.