DR. ANGELA DECARLA JACKSON (NPI# 1194267476) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194267476 |
| Entity Type | Individual |
| Full Name | DR. ANGELA DECARLA JACKSON |
| Credential | PH.D., LCPC, NCC |
| Practice Address |
900 S Clark St Apt 2213 Chicago IL 60605-3708 |
| Mailing Address |
1016 W Jackson Blvd # 700 Chicago IL 60607-2914 |
| Practice Telephone | 3127614441 |
| Mailing Telephone | 3127614441 |
| Enumeration Date | 2016-11-17 |
| Last Update Date | 2020-05-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
180011258 | IL | Behavioral Health & Social Service Providers |
| N | 101YP2500X |
Counselor Specialization: Professional |
C.1400533 | OH | Behavioral Health & Social Service Providers |
| N | 101YP2500X |
Counselor Specialization: Professional |
178.011168 | IL | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 180 N Michigan Ave, Suite 410, Chicago, IL 606017401 | 3122574710 | |
| 900 S Clark St Apt 2213, Chicago, IL 606053708 | 3126386477 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831796143 | Angela M Jackson | Massage Therapist | 8795 Ralston Rd Ste 202d, Arvada, CO 80002-2357 | 2020-10-08 |
| 1104431790 | Angela P Jackson | Technician | 5528 Meadow Passage Dr, Canal Winchester, OH 43110-8397 | 2020-09-10 |
| 1316446453 | Angela Evonne Jackson | Massage Therapist | 12336 Shady Spring Way, Orlando, FL 32828-9172 | 2018-02-05 |
| 1972029858 | Angela Jackson | Adult Companion | 2469 E Dublin Granville Rd #298155, Columbus, OH 43229 | 2017-08-22 |
| 1013468248 | Angela Jackson | Specialist | 110 E St, Pittsfield, ME 04967-5106 | 2016-10-24 |
| 1609231000 | Angela Jackson | Specialist | 1110 N 47th St, Kansas City, KS 66102-1702 | 2015-12-29 |
| 1215329032 | Angela Yvette Jackson | Psychologist | 185 N Pearl Lake Cswy, #106, Altamonte Springs, FL 32714-2956 | 2015-03-03 |
| 1043636343 | Angela Jackson | Licensed Practical Nurse | 13 Slate Creek Dr Apt 5, Cheektowaga, NY 14227-2947 | 2014-03-11 |
| 1659619328 | Angela Wendy Jackson | Registered Nurse | 8299 Cambridge St, 1602, Houston, TX 77054-3170 | 2013-01-30 |
| 1952695652 | Angela Michelle Jackson | Counselor | 2501 Hunters Hill Dr, Apt. 721, Enid, OK 73703-2311 | 2011-05-31 |
| Street Address |
900 S CLARK ST APT 2213 |
| City | CHICAGO |
| State | IL |
| Zip Code | 60605-3708 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881215374 | Culturally Competent Therapy Pllc | Counselor | 900 S Clark St Apt 2213, Chicago, IL 60605-3708 | 2020-05-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568074219 | Kheri Dunkins | Counselor | 1136 S Delano Ct, Suite B201, Chicago, IL 60605 | 2020-08-22 |
| 1134739196 | Erin Odonnell | Physical Therapist | 1255 Soputh State Street, Unit 6, Chicago, IL 60605 | 2020-08-05 |
| 1225658032 | Rita Haber | Speech-Language Pathologist | 1255 S Michigan Avenue, 207, Chicago, IL 60605 | 2020-04-21 |
| 1285288753 | My Travel Guy, Inc. | Transportation Broker | 1300 S. Wabash Ave. Suite # 205, Chicago, IL 60605 | 2019-08-01 |
| 1699230417 | Iesha Marsh | Home Health Aide | 820 S Park Terrance, Apt813, Chicago, IL 60605 | 2019-02-06 |
| 1538633482 | Sara Miller | Counselor | 401 S. Lasalle St. Suite 800h, Chicago, IL 60605 | 2019-01-14 |
| 1992203798 | Lorna Johnson | Nurse Practitioner | 1740 W Taylor St., 764e Uih, Mc 509, Chicago, IL 60605 | 2018-01-26 |
| 1790226207 | Undine and Associates | Social Worker | 410 S. Michigan Ave, Ste 943, Chicago, IL 60605 | 2017-03-16 |
| 1659811529 | Paul Parpart | Occupational Therapist | 1235 S Prairie, Chicago, IL 60605 | 2017-02-27 |
| 1144679879 | Osco Drug | Ambulance | 1529 S State St 6e, Chicago, IL 60605 | 2016-06-03 |
| Find all providers in zip 60605 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609477579 | Shantrell Patrice Sutton | Counselor | 5042 W Erie St, Chicago, IL 60644-1604 | 2020-11-05 |
| 1073114591 | Alternative Schools Network | Counselor | 1807 W Sunnyside Ave, Chicago, IL 60640-5898 | 2020-11-02 |
| 1992306518 | Gravity and Grace Psychotherapy, Pllc | Counselor | 1305 S Michigan Ave Apt 602, Chicago, IL 60605-3398 | 2020-11-02 |
| 1811597263 | April Wilburne | Counselor | 804 E 54th St Apt 3, Chicago, IL 60615-4972 | 2020-10-27 |
| 1043810393 | Pamela Kranyak | Counselor | 30 N Michigan Ave Ste 925, Chicago, IL 60602-3463 | 2020-10-27 |
| 1003413378 | Erika Aguirre | Counselor | 5040 S Keating Ave., Chicago, IL 60632-4919 | 2020-10-08 |
| 1497361661 | Michael V Biederman | Counselor | 4254 N Mozart St Apt 2s, Chicago, IL 60618-1784 | 2020-09-22 |
| 1013523984 | Antionette Fisher | Counselor | 5703 S Peoria St, Chicago, IL 60621-2262 | 2020-09-16 |
| 1114532561 | Nefesh Counseling, LLC | Counselor | 3320 W Foster Ave # 124, Chicago, IL 60625-4813 | 2020-09-12 |
| 1114531043 | Katherine E Evans | Counselor | 1528 W Jonquil Ter Unit 2c, Chicago, IL 60626-5932 | 2020-09-08 |
| Find all providers in CHICAGO | ||||
Please comment or provide details below to improve the information on DR. ANGELA DECARLA 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.