DIANE R JACKSON (NPI# 1811056658) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811056658 |
| Entity Type | Individual |
| Full Name | DIANE R JACKSON |
| Practice Address |
87 W 4th St Mansfield OH 44903-1672 |
| Mailing Address |
Po Box 1573 Mansfield OH 44901-1573 |
| Practice Telephone | 4195264603 |
| Practice Fax Number | 4195264603 |
| Mailing Telephone | 4195264603 |
| Mailing Fax Number | 4195264603 |
| Enumeration Date | 2006-12-07 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 101Y00000X | Counselor | E.0003808-SUPV | OH | Behavioral Health & Social Service Providers |
| X | 101YM0800X |
Counselor Specialization: Mental Health |
E.0003808-SUPV | OH | Behavioral Health & Social Service Providers |
| X | 101YP1600X |
Counselor Specialization: Pastoral |
E.0003808-SUPV | OH | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588212872 | Diane Marie Jackson | Occupational Therapist | 1279 Elmhurst Dr Ne, Cedar Rapids, IA 52402-4760 | 2019-08-29 |
| 1720408966 | Diane Jackson | Behavioral Analyst | 981 W Simkins Rd, Pahrump, NV 89060-2688 | 2014-04-25 |
| 1467796128 | Diane Regina Jackson | Nurse Practitioner | 1248 E Hillsborough Ave, 221, Tampa, FL 33604-7201 | 2012-11-19 |
| 1063768521 | Diane Marie Jackson | Registered Nurse | 12517 Erwin Ave, Cleveland, OH 44135-3554 | 2012-08-01 |
| 1366729493 | Diane Jackson | Social Worker | 9416 Creek Summit Cir, Richmond, VA 23235-4277 | 2011-11-03 |
| 1073817318 | Diane Jackson | Nurse Practitioner | 25329 I-45, Suite B, The Woodlands, TX 77380 | 2010-12-30 |
| 1770777229 | Diane Lynn Jackson | Home Health | 901 Frost Hollow Dr, Desoto, TX 75115-7412 | 2007-08-28 |
| 1922160720 | Diane Rene Jackson | Social Worker | 1129 Hightower Place Dr, O Fallon, IL 62269-7069 | 2006-12-15 |
| 1710096409 | Diane Jackson | Marriage & Family Therapist | 300 Harding Blvd, Suite 109, Roseville, CA 95678-2470 | 2006-08-29 |
| 1447723994 | Diane M Jackson | Counselor | 550 W Chalmers Ave, Youngstown, OH 44511-1576 | 2019-01-08 |
| Street Address |
87 W 4TH ST |
| City | MANSFIELD |
| State | OH |
| Zip Code | 44903-1672 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568521300 | Samaritan House Counseling Services, LLC | Counselor | 87 W 4th St, Mansfield, OH 44903-1672 | 2006-12-07 |
| 1275692014 | Linda J Zakrajsek | Counselor | 87 W 4th St, Mansfield, OH 44903-1672 | 2006-12-07 |
| 1467511204 | John A Squires | Counselor | 87 W 4th St, Mansfield, OH 44903-1672 | 2006-12-07 |
| 1548329394 | Dale C. Traven | Counselor | 87 W 4th St, Mansfield, OH 44903-1672 | 2006-12-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710495304 | Meredith Remy | Specialist/Technologist | 864 St. Rt. 314 S, Mansfield, OH 44903 | 2018-01-17 |
| 1639695174 | Judd Mateo | Home Health Aide | 1027 Neil Circle N., Mansfield, OH 44903 | 2017-08-16 |
| 1942722517 | Leighana Nichole Smith | Licensed Practical Nurse | 1451 Lucas Rd., Mansfield, OH 44903 | 2017-07-14 |
| 1528481710 | Sarah Elizabeth Hoffman | Occupational Therapy Assistant | 1600 Crider Rd., Mansfield, OH 44903 | 2014-01-24 |
| 1881025195 | Erica Renee Hanley | Occupational Therapy Assistant | 1600 Crider Road, Mansfield, OH 44903 | 2013-12-12 |
| 1164768917 | Colette Elaine Germann | Licensed Practical Nurse | 695 Satinwood N Cr, Mansfield, OH 44903 | 2012-12-26 |
| 1386996577 | Nicky Lynn Cole | Home Health Aide | 135 Columbia Avenue, Mansfield, OH 44903 | 2012-10-11 |
| 1215217989 | Darein Lee Wilson | Nurse's Aide | 175 Colonial Drive, Mansfield, OH 44903 | 2011-08-25 |
| 1205070802 | Simone Nannette Robinson | Licensed Practical Nurse | 576 Garfield Place, Mansfield, OH 44903 | 2009-04-27 |
| 1659518991 | Amelia Faye Johnson Grund | Nurse Practitioner | 336 Glessner Ave, Mob 2nd Fl, Mansfield, OH 44903 | 2009-01-08 |
| Find all providers in zip 44903 | ||||
| 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 |
|---|---|---|---|---|
| 1871103283 | Be Still Counseling and Consulting, Pllc | Counselor | 602 Strada Cir Ste 119, Mansfield, TX 76063-3201 | 2020-08-01 |
| 1407407620 | Ryan Edward Rodrigues | Counselor | 792 S Main St Ste 102, Mansfield, MA 02048-3137 | 2019-09-28 |
| 1356871131 | Roger Noe | Counselor | 652 Holiday Dr, Mansfield, OH 44904-1819 | 2017-06-14 |
| 1497291389 | Latieria Edwards | Counselor | 606 Monroe St, Mansfield, LA 71052-3224 | 2017-01-16 |
| 1962959130 | Lakimberly Pratt Edwards | Counselor | 1048 Park Dr, Mansfield, LA 71052-4812 | 2016-09-06 |
| 1154780880 | Jacarri Jackson | Counselor | 238 Wildwood St, Mansfield, LA 71052-6420 | 2016-02-23 |
| 1619342433 | Stanley Cunningham | Counselor | 125 Canary Lane, Mansfield, LA 71052 | 2015-12-04 |
| 1083036545 | Roger Higginbotham | Counselor | 151 Marion Avenue, Mansfield, OH 44903-2223 | 2014-01-16 |
| 1649608431 | Giscard Sarkis | Counselor | 19 Homefield Dr # Dt, Mansfield, MA 02048-3330 | 2013-10-15 |
| 1932548856 | Jessica Alexis Taylor | Counselor | 641 Scholl Rd., Mansfield, OH 44907 | 2013-06-25 |
| Find all providers in MANSFIELD | ||||
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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.