MS. CHEVON JACKSON (NPI# 1740767649) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740767649 |
| Entity Type | Individual |
| Full Name | MS. CHEVON JACKSON |
| Credential | MSW |
| Practice Address |
525 Nw Lake Whitney Pl Ste 102 Port St Lucie FL 34986-1605 |
| Mailing Address |
516 Olive Tree Cir Greenacres FL 33413-3052 |
| Practice Telephone | 7723378164 |
| Practice Fax Number | 7723378165 |
| Mailing Telephone | 9543267776 |
| Enumeration Date | 2018-07-24 |
| Last Update Date | 2018-07-24 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
10018 | FL | Behavioral Health & Social Service Providers |
| Street Address |
525 NW LAKE WHITNEY PL STE 102 |
| City | PORT ST LUCIE |
| State | FL |
| Zip Code | 34986-1605 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487901187 | Pamela Jewell Givans | Counselor | 525 Nw Lake Whitney Pl Ste 102, Port St Lucie, FL 34986-1605 | 2012-08-13 |
| 1326507427 | Grace Antoinette Irving | Counselor | 525 Nw Lake Whitney Pl Ste 102, Port St Lucie, FL 34986-1605 | 2019-03-18 |
| 1760984553 | Edmond Louis Metellus | Case Manager/Care Coordinator | 525 Nw Lake Whitney Pl Ste 102, Port St Lucie, FL 34986-1605 | 2018-03-07 |
| 1558874164 | Christina Ann Porto | Social Worker | 525 Nw Lake Whitney Pl Ste 102, Port St Lucie, FL 34986-1605 | 2017-11-06 |
| 1831601871 | Megan G Pack | Case Manager/Care Coordinator | 525 Nw Lake Whitney Pl Ste 102, Port St Lucie, FL 34986-1605 | 2017-10-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962992933 | Lindsay B Rojas | Occupational Therapist | 827 Sw Grand Reserves Blvd, Port St Lucie, FL 34986 | 2018-05-15 |
| 1639685266 | Natoya A Queenbourrows | Family Medicine | 2145 Nw Padova St, Port St Lucie, FL 34986 | 2017-12-19 |
| 1740634930 | The Toledo Clinic, LLC | Clinic/Center | 5481 Nw East Torino Parkway, Port St. Lucie, FL 34986 | 2016-04-14 |
| 1326407230 | Merline Smellie | Social Worker | 525 Nw Lake Whitney Place, Ste 102 & 103, Port St Lucie, FL 34986 | 2016-02-19 |
| 1124486949 | Therapy Connection of The Treasure Coast | Speech-Language Pathologist | 549 Nw Lake Whitney Pl Ste 104, Port St Lucie, FL 34986 | 2016-02-08 |
| 1689050015 | Yudelquis Comas Sanchez | Internal Medicine | Lawnwood Regional Medical Center, 1700 S 23rd St, Fort Pierce, FL 34986 | 2015-08-07 |
| 1689056889 | Joshua Chupp | Dentist | 1384 Sw St. Lucie West Blvd, Port St. Lucie, FL 34986 | 2015-06-24 |
| 1366821720 | Kids Therapy Solutions | Occupational Therapist | 161 Sw Palm Dr # 201, Port St Lucie, FL 34986 | 2015-05-19 |
| 1134514086 | Comfortable Care Dental Health Professionals, Pa | Dentist | 1384 Sw St. Lucie, Port St. Lucie, FL 34986 | 2015-03-30 |
| 1750787586 | Timothy Michael Kennedy | Chiropractor | 1680 Sw Saint Lucie West Blvd Ste 204, Port St Lucie, FL 34986 | 2014-11-05 |
| Find all providers in zip 34986 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801403357 | Samantha Dunbar | Counselor | 2221 Se Mcmaster St, Port St Lucie, FL 34952-6845 | 2020-09-29 |
| 1629699129 | Justine Renee Sommers | Counselor | 131 Nw Swann Mill Cir, Port St Lucie, FL 34986-3591 | 2020-05-06 |
| 1457830853 | Cathy L Sonier | Counselor | 357 Brazilian Circle, Port St Lucie, FL 34952 | 2018-08-07 |
| 1184139123 | Malita Robinson | Counselor | 113 Se Whitmore Dr, Port St Lucie, FL 34984-3738 | 2017-12-13 |
| 1316456387 | Misty Brooke Rummage | Counselor | 354 Se Greenway Ter, Port St Lucie, FL 34983-2696 | 2017-09-21 |
| 1801312590 | Hazel Mentore | Counselor | 1358 Sw Century Ave, Port St Lucie, FL 34953 | 2017-08-15 |
| 1528580313 | Garland Anderson | Counselor | 2100 Se Hillmoor Dr Ste 205, Port St Lucie, FL 34952-8057 | 2017-07-13 |
| 1437689601 | Jacquelyn Morris | Counselor | 6041 Nw Wesley Rd, Port St Lucie, FL 34986-3752 | 2017-06-19 |
| 1194250753 | Magaly Marin | Counselor | 562 Sw Violet Ave, Port St Lucie, FL 34983-8739 | 2017-04-20 |
| 1861923815 | Vivas Counseling Services, LLC | Counselor | 6550 S Federal Hwy, Port St Lucie, FL 34952-9031 | 2017-03-22 |
| Find all providers in PORT ST LUCIE | ||||
| City | PORT ST LUCIE |
| Zip Code | 34986 |
Please comment or provide details below to improve the information on MS. CHEVON 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.