CAMILLE JEWELL JACKSON (NPI# 1558996132) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558996132 |
| Entity Type | Individual |
| Full Name | CAMILLE JEWELL JACKSON |
| Practice Address |
8181 N Wayne Rd Apt S2147 Westland MI 48185-3842 |
| Practice Telephone | 3135290006 |
| Mailing Telephone | 3135290006 |
| Enumeration Date | 2020-03-04 |
| Last Update Date | 2020-03-04 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 175T00000X | Peer Specialist | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902252950 | Camille Jackson | Occupational Therapy Assistant | 5199 W Oak Grove Ln, Highland, UT 84003-9469 | 2016-05-09 |
| 1134574528 | Camille Jackson | Student in an Organized Health Care Education/Training Program | 1411 E 31st St, Department of Surgery, Oakland, CA 94602-1018 | 2016-05-04 |
| 1093171159 | Camille Jackson | Specialist | 7000 Austin St, Suite200, Forest Hills, NY 11375-1022 | 2016-01-05 |
| Street Address |
8181 N WAYNE RD APT S2147 |
| City | WESTLAND |
| State | MI |
| Zip Code | 48185-3842 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457821084 | Kimberly L Traver | Nurse Practitioner | 6149 N. Wayne Road, Westland, MI 48185 | 2018-11-27 |
| 1710456421 | Infinity Physical Therapy | Occupational Therapy Assistant | 36413 Warren Road, Westland, MI 48185 | 2018-11-26 |
| 1770071391 | Woodcrest Rx LLC. | Pharmacy | 8301 North Wayne Rd., Westland, MI 48185 | 2018-04-30 |
| 1922522952 | Regina Amadi | Pharmacist | 30785 Ann Arbor Trail, Westland, MI 48185 | 2017-08-01 |
| 1811417637 | Jacob Davis Adams | Specialist/Technologist | 34610 Parkgrove, Westland, MI 48185 | 2017-06-22 |
| 1336677533 | Mark Brian Beathard | Counselor | 8623 N. Wayne Road, Suite 310, Adult Outpatient Services for Smi, Westland, MI 48185 | 2017-06-01 |
| 1164965240 | Murray Dalton | Social Worker | 8623 N. Wayne Rd, Suite 310, Westland, MI 48185 | 2016-11-22 |
| 1962953505 | Krishaun Harris | Technician, Other | 8181 N.wayne Rd, Apt.2131, Westland, MI 48185 | 2016-10-19 |
| 1417408089 | Joseph E Silver Dpm PC | Podiatrist | 35337 W Warren Ave, Westland, MI 48185 | 2016-10-19 |
| 1043769813 | Joy Hix Pharmacy LLC | Pharmacy | 38409 Joy Rd, Westland, MI 48185 | 2016-09-22 |
| Find all providers in zip 48185 | ||||
| Taxonomy Code | 175T00000X |
| Grouping | Other Service Providers |
| Classification | Peer Specialist |
| Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. |
| Notes: Source: National Uniform Claim Committee [7/1/2014: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447654629 | Judith Chapman | Peer Specialist | 31686 Kara Ln, Apt 107, Westland, MI 48186-5580 | 2014-10-16 |
| 1457968364 | Jamie Michelle Giamanco | Peer Specialist | 32715 Dorsey St, Westland, MI 48186-4755 | 2020-09-24 |
| 1689221178 | James Cedric Dubois Jr. | Peer Specialist | 32715 Dorsey St, Westland, MI 48186-4755 | 2019-08-20 |
| 1114436524 | Adrienne Kay Mccain | Peer Specialist | 8623 N Wayne Rd Ste 123, Westland, MI 48185-1137 | 2017-09-28 |
| 1285183434 | Linda Vecchioni | Peer Specialist | 32715 Dorsey St, Westland, MI 48186-4755 | 2016-09-29 |
| 1962806612 | Tom Rucinski | Peer Specialist | 8623 N Wayne Rd, Westland, MI 48185-1137 | 2014-10-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063026284 | Leah Mae Sindone | Peer Specialist | 22324 Derby Rd, Woodhaven, MI 48183-3700 | 2020-09-04 |
| 1992314728 | Willie Earl Feggins | Peer Specialist | 370 Country Club Rd, Holland, MI 49423-8303 | 2020-07-28 |
| 1831711613 | John Lee Williams Jr. | Peer Specialist | 24400 Schoolcraft, Redford, MI 48239-2633 | 2020-05-14 |
| 1568084861 | Zannie Roy Jackson Jr. | Peer Specialist | 36801 Ann Arbor Trl, Livonia, MI 48150-3422 | 2020-05-11 |
| 1417578865 | Veronica R Vasquez | Peer Specialist | 500 Hancock St # 48602, Saginaw, MI 48602-4224 | 2020-04-27 |
| 1235768680 | Matthew Milz | Peer Specialist | 145o S Lapeer Rd, Oxford, MI 48371-4982 | 2020-04-07 |
| 1073146908 | James Laroach | Peer Specialist | 913 W. Homes Suite 200, Lansing, MI 48910 | 2020-02-19 |
| 1578193827 | Axel Lee Gruenberg | Peer Specialist | 221790 West 9 Mile, Southfield, MI 48033 | 2020-01-24 |
| 1962032078 | Brianne Salchert | Peer Specialist | 1170 Michigan Rd., Port Huron, MI 48060 | 2020-01-17 |
| 1003453267 | Patricia Ann Love | Peer Specialist | Training& Treatment Innovations,inc, 929 Stevenson St, Flint, MI 48502 | 2019-12-06 |
| Find all providers with the same taxonomy | ||||
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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.