MS. LYNN JACKSON (NPI# 1609203694) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609203694 |
| Entity Type | Individual |
| Full Name | MS. LYNN JACKSON |
| Credential | M.A., L.L.P. |
| Practice Address |
456 Plymouth Ave Ne Ste B Grand Rapids MI 49505 |
| Mailing Address |
2324 Southgate Dr Se Kentwood MI 49508-0951 |
| Practice Telephone | 6163450414 |
| Mailing Telephone | 6163450414 |
| Enumeration Date | 2013-10-04 |
| Last Update Date | 2018-07-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC1900X |
Psychologist Specialization: Counseling |
6301009521 | MI | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497129472 | Lynn Jackson | Counselor | 3869 Terrybrook Rd, West Bloomfield, MI 48322-1737 | 2015-11-13 |
| 1437558285 | Lynn Jackson | Behavioral Analyst | 495 Manhattan Ave, New York, NY 10027-5237 | 2014-08-18 |
| 1689779522 | Lynn C Jackson | Physical Therapist | 6012 W William Cannon Dr, Bldg C, Austin, TX 78749-1980 | 2006-09-14 |
| Street Address |
456 PLYMOUTH AVE NE STE B |
| City | GRAND RAPIDS |
| State | MI |
| Zip Code | 49505 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457886202 | Heidi Christine Kaltenbacher | Social Worker | 456 Plymouth Ave Ne Ste B, Grand Rapids, MI 49505 | 2017-04-28 |
| 1932599453 | Holly Bathrick | Social Worker | 456 Plymouth Ave Ne Ste B, Grand Rapids, MI 49505 | 2015-02-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285276097 | Molly Beth Kerkstra | Home Health Aide | 1115 Ball Ave Nw, Grand Rapids, MI 49505 | 2019-10-14 |
| 1154849677 | Roshawn Nichol Whitley | Technician | 891 Maryland Ave, Grand Rapids, MI 49505 | 2017-09-05 |
| 1447778923 | Kelly Benzin-brinks | Social Worker | 1965 3 Mile Rd Ne, Grand Rapids, MI 49505 | 2017-09-05 |
| 1033560404 | Taylor Nolan Boyd | Speech-Language Pathologist | 400 Ann St Ne Ste 106a, Grand Rapids, MI 49505 | 2016-06-28 |
| 1023465002 | Calvin Athy | Counselor | 1101 Ballave Ne, Grand Rapids, MI 49505 | 2016-05-19 |
| 1821456682 | Kelly Van Huisen | Counselor | 1115 Ball Avenue Ne, Building B, Grand Rapids, MI 49505 | 2016-02-08 |
| 1780051102 | Mark Squeteri | Social Worker | 1345 Monroe Ave Nw Ste 234, Grand Rapids, MI 49505 | 2015-09-02 |
| 1346637337 | Shelby Fullington | Social Worker | 1011 Ball Ave Ne, Grand Rapids, MI 49505 | 2015-04-17 |
| 1457745325 | Lester Anderson II | Social Worker | 1115 Ball Ave, Grand Rapids, MI 49505 | 2015-03-27 |
| 1730570151 | Nicole Brown | Counselor | 1345 Monroe Ave Nw Ste 204, Grand Rapids, MI 49505 | 2015-02-06 |
| Find all providers in zip 49505 | ||||
| Taxonomy Code | 103TC1900X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Counseling |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609416197 | Alexander Sydney Houseknecht | Psychologist | 337 Visser Pl Se, Grand Rapids, MI 49506-1541 | 2020-01-13 |
| 1730745852 | Kls Counseling LLC | Psychologist | 688 Cascade West Pkwy Se, Grand Rapids, MI 49546-2171 | 2019-05-14 |
| 1609347285 | Luwillis Gibson | Psychologist | 1014 Dunham St Se, Grand Rapids, MI 49506-2659 | 2018-12-07 |
| 1598257966 | Austin Knight | Psychologist | 1010 Watson St Sw, Grand Rapids, MI 49504-6148 | 2018-06-01 |
| 1184996969 | Joseph Edward Budnick | Psychologist | 1150 Brownwood Ave Nw, Grand Rapids, MI 49504-3653 | 2012-02-08 |
| 1265660963 | Gary Michael Cole | Psychologist | 1115 Ball Ave Ne Bldg C, Grand Rapids, MI 49505-5904 | 2009-07-01 |
| 1073763710 | Kylene Lynn Schipper | Psychologist | 3300 36th St, Grand Rapids, MI 49518-0007 | 2008-09-30 |
| 1295986933 | Jeffrey Alan Bootzin | Psychologist | 330 Eastern Ave Se, Grand Rapids, MI 49503-4737 | 2008-09-30 |
| 1770730434 | Kurt Thomas Ellis | Psychologist | 4920 Plainfield Ave Ne, Suite C, Grand Rapids, MI 49525-1010 | 2008-08-25 |
| 1437332871 | Jeanette Mcdowell Forrest | Psychologist | 233 Fulton St E Ste 104, Grand Rapids, MI 49503-3261 | 2007-12-07 |
| Find all providers in GRAND RAPIDS | ||||
| City | GRAND RAPIDS |
| Zip Code | 49505 |
Please comment or provide details below to improve the information on MS. LYNN 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.