MS. MELISSA RENA JACKSON (NPI# 1609145184) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609145184 |
| Entity Type | Individual |
| Full Name | MS. MELISSA RENA JACKSON |
| Credential | MHR, LPC |
| Practice Address |
11541 Village Ave Midwest City OK 73130-8207 |
| Practice Telephone | 4052013646 |
| Mailing Telephone | 4052013646 |
| Enumeration Date | 2011-12-29 |
| Last Update Date | 2013-08-29 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | OK | Behavioral Health & Social Service Providers | |
| N | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093298655 | Melissa Marie Jackson | Registered Nurse | 456 W 68th St, Kansas City, MO 64113-1919 | 2018-09-10 |
| 1891235933 | Melissa Jackson | Marriage & Family Therapist | 202 W Manchester Ave, Playa Del Rey, CA 90293-7710 | 2017-03-07 |
| 1881086577 | Melissa Jackson | Dentist | 2539 S Columbia Pl, Tulsa, OK 74114-3232 | 2015-03-04 |
| 1346645231 | Melissa Rene Jackson | Advanced Practice Midwife | 2744 Ewing Ave S, Minneapolis, MN 55416-4213 | 2014-11-04 |
| 1992048482 | Melissa Michelle Jackson | Speech-Language Pathologist | 707 Marie Ave, Ruston, LA 71270-2715 | 2013-04-03 |
| 1033471065 | Melissa Anne Jackson | Specialist | 3133 Broadway Apt 1, New York, NY 10027-4617 | 2012-06-14 |
| 1538439112 | Melissa Jackson | Spec/Tech, Pathology | 1820 California St Nw, 41, Washington, DC 20009-1824 | 2012-01-12 |
| 1497064695 | Melissa Lousie Jackson | Neuromusculoskeletal Medicine, Sports Medicine | 4 Victory Ln, Scarborough, ME 04074-8486 | 2010-10-05 |
| 1528224219 | Melissa Jackson | Psychiatry & Neurology | 3250 Ne 1st Ave, Suite 317, Miami, FL 33137-4191 | 2008-08-01 |
| 1063681526 | Melissa Odette Vega Jackson | Occupational Therapist | 3773 Seven Seas Ave, Land O Lakes, FL 34638-2905 | 2008-02-28 |
| Street Address |
11541 VILLAGE AVE |
| City | MIDWEST CITY |
| State | OK |
| Zip Code | 73130-8207 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366059909 | Richard Williams | Behavior Technician | 1121 S. Douglas Boulevard, Suite A, Midwest City, OK 73130 | 2020-09-28 |
| 1730794264 | Cassidy Myers | Behavioral Analyst | 1121 South Douglas Boulevard, Suite A, Midwest City, OK 73130 | 2020-09-11 |
| 1831609320 | Progressive Home Health Inc | Home Health | 9070 Harmony Dr Ste C, Midwest City, OK 73130 | 2017-10-10 |
| 1306290903 | Maria Soledad Dabney | Counselor | 9101 Stonegate, Oklahoma City, OK 73130 | 2016-04-20 |
| 1922452804 | Endodontics and Implant Associates,pllc | Dentist | 1621 Midtown Place, Suite B, Midwest City, OK 73130 | 2016-04-18 |
| 1639574130 | Healthcare Express, LLP | Clinic/Center | 1701 S. Douglas Blvd., Midwest City, OK 73130 | 2014-10-27 |
| 1891045274 | Michelle Lynn Goolsby | Behavioral Analyst | 10822 Blue Sky Drive, Midwest City, OK 73130 | 2012-09-13 |
| 1497026173 | Deberry Interprise | Community/Behavioral Health | 9233 North East10th Street, Midwest City, OK 73130 | 2012-01-26 |
| 1245531789 | Nichelle Stewart | Counselor | 10520 Quail Run Road, Midwest City, OK 73130 | 2010-11-16 |
| 1477877835 | Jan Bierne, Inc. | Counselor | 2912 S. Douglas Blvd, Suite A, Midwest City, OK 73130 | 2010-03-15 |
| Find all providers in zip 73130 | ||||
| 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 |
|---|---|---|---|---|
| 1467068098 | Mckenzie Mcguffee | Counselor | 717 Briarcrest Dr, Midwest City, OK 73110-1619 | 2020-09-18 |
| 1457883662 | Melissa Lynn Russell | Counselor | 808 Hunters Run, Midwest City, OK 73130-4528 | 2017-03-28 |
| 1629427612 | Tiffney Simmons | Counselor | 8818 Ne 13th St, Midwest City, OK 73110-7120 | 2016-06-09 |
| 1639536212 | Jenell Mapp | Counselor | 1716 S Willow Wind Dr, Midwest City, OK 73130-6511 | 2016-01-27 |
| 1831564251 | Traci Johnson | Counselor | 8811 Fairfield Greens Dr, Midwest City, OK 73110-8015 | 2015-12-10 |
| 1396115788 | Ramona Nicholson | Counselor | 10525 Quail Run Rd, Midwest City, OK 73130-7039 | 2015-09-29 |
| 1619346103 | Heather Kelpine | Counselor | 9677 Oak Tree Ter, Midwest City, OK 73130-3537 | 2015-09-15 |
| 1164842084 | Willard Frazier Jr. | Counselor | 4406 N Shadybrook Dr, Midwest City, OK 73110-3437 | 2014-04-17 |
| 1467877019 | Megan Leigh Kilmer | Counselor | 1800 Rulane Dr, Midwest City, OK 73110-2561 | 2014-02-19 |
| 1437573672 | Anthony Jerome Gilliam | Counselor | 2424 N Key Blvd, Midwest City, OK 73110-4662 | 2014-02-07 |
| Find all providers in MIDWEST CITY | ||||
| City | MIDWEST CITY |
| Zip Code | 73130 |
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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.