BEATRICE JACKSON (NPI# 1356825954) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356825954 |
| Entity Type | Individual |
| Full Name | BEATRICE JACKSON |
| Credential | SUD COUNSELOR SAC |
| Practice Address |
4800 S 10th St Milwaukee WI 53221-2412 |
| Practice Telephone | 4147445370 |
| Practice Fax Number | 4147449052 |
| Mailing Telephone | 4147445370 |
| Mailing Fax Number | 4147444352 |
| Enumeration Date | 2018-09-19 |
| Last Update Date | 2018-09-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
15667-131 | WI | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649768672 | Beatrice Kasey Jackson | Behavior Technician | 1411 S Socorro St, Deming, NM 88030 | 2018-04-25 |
| 1669877460 | Beatrice Jackson | Non-emergency Medical Transport (VAN) | 14100 Bardwell Avenue, East Cleveland, OH 44112 | 2014-10-23 |
| 1306317540 | Beatrice Latricia Jackson | Behavior Technician | 5300 Lennox Ave Ste 100, Bakersfield, CA 93309-1662 | 2018-12-16 |
| Street Address |
4800 S 10TH ST |
| City | MILWAUKEE |
| State | WI |
| Zip Code | 53221-2412 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750427167 | Catherine D'alessio | Counselor | 4800 S 10th St, Milwaukee, WI 53221-2412 | 2007-01-30 |
| 1063035681 | Amelia C Niesen | Registered Nurse | 4800 S 10th St, Milwaukee, WI 53221-2412 | 2020-05-19 |
| 1396306775 | Tesa Zackery | Counselor | 4800 S 10th St, Milwaukee, WI 53221-2412 | 2019-06-26 |
| 1083270946 | Vickie Banaszynski | Registered Nurse | 4800 S 10th St, Milwaukee, WI 53221-2412 | 2019-05-16 |
| 1023671500 | Benito Cruz-sanchez | Technician | 4800 S 10th St, Milwaukee, WI 53221-2412 | 2019-04-19 |
| 1356803100 | Sophia Branen | Registered Nurse | 4800 S 10th St, Milwaukee, WI 53221-2412 | 2019-04-02 |
| 1750842969 | Loretta Mummer | Licensed Practical Nurse | 4800 S 10th St, Milwaukee, WI 53221-2412 | 2019-03-29 |
| 1346707346 | Stephanie Popoutsis | Technician | 4800 S 10th St, Milwaukee, WI 53221-2412 | 2019-02-26 |
| 1952868036 | Rafal Zerebecki | Technician | 4800 S 10th St, Milwaukee, WI 53221-2412 | 2019-02-26 |
| 1780141879 | Madeleine L Boman | Technician | 4800 S 10th St, Milwaukee, WI 53221-2412 | 2019-02-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487205944 | Hayat Pharmacy 20 LLC | Pharmacy | 805 W. Layton Ave., Suite B, Milwaukee, WI 53221 | 2019-09-26 |
| 1962053421 | Hayat Pharmacy 19 LLC | Pharmacy | 805 W. Layton Ave. Suite A, Milwaukee, WI 53221 | 2019-09-26 |
| 1407343965 | Informe Healthcare LLC | Counselor | 2741 W Layton Ave., Suite 106, Milwaukee, WI 53221 | 2018-04-19 |
| 1447781992 | Itamar Yaakov Gnatt | Emergency Medicine | 2900 W Oklahoma Ave, St Lukes Medical Center, Milwaukee, WI 53221 | 2017-03-27 |
| 1194277160 | Suzanne Derosier | Licensed Practical Nurse | 3910 W Bridge, Greenfield, WI 53221 | 2016-10-26 |
| 1265988117 | Obi Home Care | Clinic/Center | 4439 S 20th St, Milwaukee, WI 53221 | 2016-08-31 |
| 1427430602 | Zezenya Health Care S.c. | Pain Medicine | 5114 S 27th St # 763, Milwaukee, WI 53221 | 2015-06-24 |
| 1851771091 | Feisal J Salahadyn | Counselor | 4800 South 10th Street, Milwaukee, WI 53221 | 2015-06-03 |
| 1114312386 | Holistic Home Health Care Incorporated | Adult Companion | 3422 West Howard Ave, Greenfield, WI 53221 | 2015-04-03 |
| 1841698834 | Srt Prosthetics & Orthotics LLC | Prosthetic/Orthotic Supplier | 5220 S 27th St., Milwaukee, WI 53221 | 2014-12-08 |
| Find all providers in zip 53221 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649879982 | Veronicia S Green | Counselor | 2821 N Vel R Phillips Ave Ste 131, Milwaukee, WI 53212-2370 | 2020-10-19 |
| 1932733193 | 1 Step Away Divine Counseling Service LLC | Counselor | 6815 W Capitol Dr Ste 308, Milwaukee, WI 53216-2056 | 2020-02-26 |
| 1689216293 | Carollyn Black | Counselor | 4892 N 19th St, Milwaukee, WI 53209-5757 | 2019-10-15 |
| 1861046146 | Lisa Marie Ortiz | Counselor | 3336 S 76th St, Milwaukee, WI 53219-3805 | 2019-07-25 |
| 1891359576 | Kenneth Ginlack Sr Consulting Services LLC | Counselor | 3927 S Howell Ave Ste 102, Milwaukee, WI 53207-4421 | 2019-04-27 |
| 1649733189 | Stacey King | Counselor | Rivershore Comprehensive Treatment Facility, 3703 N Richards St, Milwaukee Wi, Milwaukee, WI 53212 | 2019-04-11 |
| 1821561168 | Lydia Ann Mendez | Counselor | 3703 N Richards St, Milwaukee, WI 53212 | 2019-01-09 |
| 1851863302 | Glen Victor Fleming | Counselor | 2821 North 4th Street Suite 210, Milwaukee, WI 53212 | 2018-12-21 |
| 1992280218 | Tanya Lynn Peters | Counselor | 9224 W Burleigh St, Milwaukee, WI 53222-3503 | 2018-10-02 |
| 1467948844 | Alexcis Coleman | Counselor | 6815 W Capitol Dr Ste 217, Milwaukee, WI 53216 | 2018-07-09 |
| Find all providers in MILWAUKEE | ||||
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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.