MS. ALFAYE JACKSON (NPI# 1770749905) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770749905 |
| Entity Type | Individual |
| Full Name | MS. ALFAYE JACKSON |
| Credential | PLPC |
| Practice Address |
1949 E Cherry St Springfield MO 65802 |
| Mailing Address |
3101c S Kimbrough Ave Springfield MO 65807-5011 |
| Practice Telephone | 4177610300 |
| Practice Fax Number | 4177610386 |
| Mailing Telephone | 4178667773 |
| Enumeration Date | 2008-08-07 |
| Last Update Date | 2019-07-24 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
2015044726 | MO | Behavioral Health & Social Service Providers |
| N | 101YP2500X |
Counselor Specialization: Professional |
2008015070 | MO | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 490047336 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1300 E Bradford Pkwy, Springfield, MO 65804 | 4177615000 | 4177615011 |
| 1949 E Cherry St, Springfield, MO 658022952 | 4177610300 | 4177610386 |
| Street Address |
1949 E CHERRY ST |
| City | SPRINGFIELD |
| State | MO |
| Zip Code | 65802 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942338504 | Burrell, Inc. | Substance Abuse Rehabilitation Facility | 1949 E Cherry St, Springfield, MO 65802-2952 | 2007-03-02 |
| 1467991380 | Amanda S Mays | Marriage & Family Therapist | 1949 E Cherry St, Springfield, MO 65802-2952 | 2017-02-13 |
| 1619301843 | Ryan K Shepherd | Counselor | 1949 E Cherry St, Springfield, MO 65802-2952 | 2013-08-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407454549 | Andrea Strauch | Counselor | 2024 W Chestnut Expressway Way, Springfield, MO 65802 | 2020-10-12 |
| 1962968867 | Chad Michael Linck | Specialist/Technologist | 2125 N Glenstone Ave, Springfield, MO 65802 | 2019-02-15 |
| 1790254647 | Meds To Live By | Pharmacist | 1134 N. Scarlett Way, Springfield, MO 65802 | 2018-11-21 |
| 1568945103 | Ficom | Non-Pharmacy Dispensing Site | 1308 North Glenstone Avenue, Springfield, MO 65802 | 2018-09-10 |
| 1982194775 | Karla Caballero | Marriage & Family Therapist | 8627 Montant Fort Way, 145, Sprinfield, MO 65802 | 2018-05-16 |
| 1780191809 | Tiffany Chawntay Coryell | Pharmacist | 1134 North Scarlett Way, Springfield, MO 65802 | 2018-01-10 |
| 1083134902 | Trevor Conner | Family Medicine | 1423 N Jefferson Ave, B100, Springfield, MO 65802 | 2017-06-21 |
| 1407389596 | Medical Mile Imaging | Radiology | 3905 E Windsmore Dr, Springfield, MO 65802 | 2017-04-06 |
| 1346619103 | Jill A Knight | Occupational Therapist | 1601 E. Pythian, Green Valley State School, Springfield, MO 65802 | 2015-09-22 |
| 1447653258 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 3720 E Sunshine St, Springfield, MO 65802 | 2014-10-07 |
| Find all providers in zip 65802 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578161964 | Joyful Living Behavioral Health Inc | Counselor | 107 W Q St, Springfield, OR 97477-2171 | 2020-10-16 |
| 1366055352 | Joshua Dauner | Counselor | 819 N Boonville Ave, Springfield, MO 65802-3831 | 2020-08-28 |
| 1972114411 | Doris Osiimwe Johnson | Counselor | 52 Elaine Cir # 52, Springfield, MA 01109-1205 | 2020-08-10 |
| 1003426610 | Jy Counseling LLC | Counselor | 6054 Forrest Hollow Ln, Springfield, VA 22152-1428 | 2020-08-07 |
| 1912526674 | Amy Christine Russell | Counselor | 317 30th St Apt 304d, Springfield, OR 97478-7619 | 2020-04-13 |
| 1588299184 | Julie Patricia Slover | Counselor | 3331 S Parkview Ave, Springfield, MO 65804-4755 | 2020-03-04 |
| 1356986319 | Three Dirty Birds LLC | Counselor | 805 Lorraine Dr, Springfield, PA 19064-1004 | 2019-11-14 |
| 1992348916 | Tiffany Looney | Counselor | 1705 Centennial Blvd Ste 1, Springfield, OR 97477-3320 | 2019-10-22 |
| 1588206346 | Carrie Stormzand | Counselor | 4546 S Quail Creek Ave, Springfield, MO 65810-1678 | 2019-10-14 |
| 1366084295 | Betty Jean | Counselor | 673 Morris Ave, Springfield, NJ 07081-1512 | 2019-10-11 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 65802 |
Please comment or provide details below to improve the information on MS. ALFAYE 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.