SIMONE RENE JACKSON (NPI# 1205214988) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205214988 |
| Entity Type | Individual |
| Full Name | SIMONE RENE JACKSON |
| Credential | MAS (AJS) |
| Practice Address |
1044 Gilbert St Flint MI 48532-3527 |
| Mailing Address |
6511 Dupont St Flint MI 48505-2068 |
| Practice Telephone | 8104229406 |
| Practice Fax Number | 8107337623 |
| Mailing Telephone | 8103483303 |
| Mailing Fax Number | 8107337623 |
| Enumeration Date | 2015-05-13 |
| Last Update Date | 2015-05-13 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740846328 | Simone Jackson | Physical Therapist | 70 Pleasant Hill Ln, Tamarac, FL 33319-2442 | 2019-05-19 |
| 1134644396 | Simone Jackson | Nurse Practitioner | 9029 S Pecos Rd Ste 2800, Henderson, NV 89074-7199 | 2017-08-09 |
| 1619483013 | Simone Jackson | Case Manager/Care Coordinator | 8745 County Road 9 S, Alamosa, CO 81101-9610 | 2017-12-20 |
| 1871041657 | Simone D Jackson | Nurse Practitioner | 680 Blair Mill Rd, Horsham, PA 19044-2223 | 2016-09-21 |
| 1437519394 | Simone Jackson | Social Worker | 3491 Gandy Blvd N, #201, Pinellas Park, FL 33781-2658 | 2016-03-03 |
| Street Address |
1044 GILBERT ST |
| City | FLINT |
| State | MI |
| Zip Code | 48532-3527 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245369867 | Kathryn Ann Bamba | Counselor | 1044 Gilbert St, Flint, MI 48532-3527 | 2007-03-02 |
| 1821654914 | Brooke June Ashley | Social Worker | 1044 Gilbert St, Flint, MI 48532-3527 | 2019-05-14 |
| 1508325200 | Susan M Card | Social Worker | 1044 Gilbert St, Flint, MI 48532-3527 | 2019-03-13 |
| 1821580721 | Judy Lynne Rogers | Counselor | 1044 Gilbert St, Flint, MI 48532-3527 | 2018-06-06 |
| 1851764534 | Kendrick Wallace | Counselor | 1044 Gilbert St, Flint, MI 48532-3527 | 2015-11-04 |
| 1669845343 | Danette Jenkins | Counselor | 1044 Gilbert St, Flint, MI 48532-3527 | 2015-11-04 |
| 1831561893 | Chauncy Wynn | Counselor | 1044 Gilbert St, Flint, MI 48532-3527 | 2015-10-29 |
| 1366820912 | Meghan Witzke | Counselor | 1044 Gilbert St, Flint, MI 48532-3527 | 2015-05-15 |
| 1487042958 | Loni King | Counselor | 1044 Gilbert St, Flint, MI 48532-3527 | 2015-01-06 |
| 1922407246 | Jeffery Joseph Brockett | Counselor | 1044 Gilbert St, Flint, MI 48532-3527 | 2014-08-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013524859 | Amber Marie Lee | Physician Assistant | 2265 South Lindenroad, Suite A, Flint, MI 48532 | 2020-09-25 |
| 1639709496 | Tammara Kamei | Counselor | 2425 S.linden Rd, Suite D Unit 100, Flint, MI 48532 | 2020-01-21 |
| 1306481882 | Christine Rice | Case Manager/Care Coordinator | 3169 Beecher Road, Flint, MI 48532 | 2019-11-08 |
| 1780154336 | Sarah Marie Shaw | Case Manager/Care Coordinator | 2091 Professional Drive, Flint, MI 48532 | 2018-11-27 |
| 1215412093 | Adria D Haynes | Social Worker | G-4413 Corunna Rd., Flint, MI 48532 | 2018-09-27 |
| 1689159378 | Vip Smiles Dentistry, Pllc | Dentist | 1104 South Linden Rd, Building B, Suite 1, Flint, MI 48532 | 2018-09-27 |
| 1942794797 | Premier Eye Specialists Pllc | Ophthalmology | 1160 S Linden Rd, Bldg. 1 Ste. A, Flint, MI 48532 | 2018-06-15 |
| 1720587710 | Cassandra Socia | Dental Hygienist | G3222 Beecher Road, Flint, MI 48532 | 2018-02-06 |
| 1235660291 | Ashley L Boltjes | Massage Therapist | 3277 Beecher Rd, Flint, MI 48532 | 2017-03-22 |
| 1497202774 | Tyneshia Mcfarland | Home Health | 2104 Ridgecliffe Dr, Flint, MI 48532 | 2016-09-05 |
| Find all providers in zip 48532 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154857423 | Carolyn Denise Scott | Counselor | 529 M.l. King, Jr. Ave., Flint, MI 48502 | 2017-05-05 |
| 1174073480 | Rooted In Love Counseling Services | Counselor | 3397 Windland Dr, Flint, MI 48504-1764 | 2016-10-11 |
| 1518319367 | Leann Littlejohn | Counselor | 529 Ml King Ave., Flint, MI 48502 | 2016-07-05 |
| 1801255054 | Jenna Pillow | Counselor | 931 Martin Luther King Ave, Flint, MI 48503-1488 | 2016-02-16 |
| 1710344841 | Virlyn Allen-poe | Counselor | 4105 Keyes St, Flint, MI 48504-2294 | 2016-01-20 |
| 1932573706 | Larry Lenoir | Counselor | G3500 Flushing Rd Ste 250, Suite 250, Flint, MI 48504-4238 | 2015-11-17 |
| 1124499835 | Harold Hill | Counselor | 323 Allendale Pl, Flint, MI 48503-2335 | 2015-10-08 |
| 1093185712 | Jayme Gene Wagner | Counselor | 529 M. L. King, Jr. Ave, Flint, MI 48502 | 2015-10-07 |
| 1821468489 | Shaun Weck | Counselor | 529 Martin Luther King Blvd # Jr, Flint, MI 48502-2002 | 2015-09-25 |
| 1427440874 | Rasheeda Mitchell | Counselor | 2387 S Linden Rd Ste 138, Flint, MI 48532-5488 | 2015-02-23 |
| Find all providers in FLINT | ||||
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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.