MR. VINCENT MAURICE JACKSON SR.


Address: 875 Mass Ave Unit 205, Indianapolis, IN 46204-1652
Phone: 3176795849

MR. VINCENT MAURICE JACKSON SR. (NPI# 1801202635) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1801202635
Entity Type Individual
Full Name MR. VINCENT MAURICE JACKSON SR.
Practice Address 875 Mass Ave Unit 205
Indianapolis
IN 46204-1652
Practice Telephone 3176795849
Mailing Telephone 3176795849
Enumeration Date 2014-07-01
Last Update Date 2014-07-01
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 103K00000X Behavioral Analyst Behavioral Health & Social Service Providers

Other Providers VINCENT JACKSON

NPI Name Taxonomy Address Enumeration
1033471669 Vincent Paul Jackson Radiologic Technologist 4950 Glaze Dr, Atlanta, GA 30360-1702 2012-06-11
1255332003 Vincent A Jackson Nurse Anesthetist, Certified Registered 3601 Tvc, Nashville, TN 37232-0001 2005-08-02
1710985783 Vincent Eugene Jackson Pharmacist 100 Hospital Rd, Pharmacy Department, Prince Frederick, MD 20678-4017 2005-07-13

Office Location

Street Address 875 MASS AVE UNIT 205
City INDIANAPOLIS
State IN
Zip Code 46204-1652

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NPI Name Taxonomy Address Enumeration
1982245593 Melvin Jay Prince Internal Medicine Gennesaret Free Clinic 615 N Alabama St, Suite 136, Indianapolis, IN 46204 2019-10-04
1487203139 Elizabeth Ann Wilson Behavior Technician 120 N East St Ste 1233, Indianapolis, IN 46204 2019-09-05
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1457853962 Tracie Lynn King Physical Therapy Assistant 500 N Capitol Ave Unit A, Indianapolis, IN 46204 2018-03-01
1013436831 Kayla Michelle Jackson Social Worker 1099 North Meridian Street, Suite 900, Indianapolis, IN 46204 2017-09-13
1912434010 Latrice N Baxter Counselor 201 N. Illinois Street, 16th Floor, South Tower, Indianpolis, IN 46204 2017-05-19
1750820643 Jcpl, LLC Optometrist 751 Massachusetts Ave, Indianapolis, IN 46204 2017-02-13
1922546969 Makenzie Brinker Specialist/Technologist 800 N. Capital Ave, 420, Indianapolis, IN 46204 2017-02-10
1598118572 Jennifer Clark Internal Medicine 1120 W. Michigan Street Gatch Hall Cl 630, Indianapolis, IN 46204 2016-07-14
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Taxonomy Information

Taxonomy Code 103K00000X
Grouping Behavioral Health & Social Service Providers
Classification Behavioral Analyst

Taxonomy Definition

A behavior analyst is qualified by at least a master’s degree and Behavior Analyst Certification Board certification and/or a state-issued credential (such as a license) to practice behavior analysis independently. Behavior analysts provide the required supervision to assistant behavior analysts and behavior technicians. A behavior analyst delivers services consistent with the dimensions of applied behavior analysis. Common services may include, but are not limited to, conducting behavioral assessments, analyzing data, writing and revising behavior-analytic treatment plans, training others to implement components of treatment plans, and overseeing implementation of treatment plans.
Notes: Source: Association of Professional Behavior Analysts, www.apbahome.net and Behavior Analyst Certification Board (http://www.bacb.com) [7/1/2008: new, 1/1/2016: modified definition]

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1124679832 Kelsey Jean Lindberg Behavioral Analyst 1722 W 16th St, Indianapolis, IN 46202-2031 2019-09-24
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Competitor

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City INDIANAPOLIS
Zip Code 46204

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Dataset Information

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.

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