TRACEY ANN JACKSON (NPI# 1861643389) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861643389 |
| Entity Type | Individual |
| Full Name | TRACEY ANN JACKSON |
| Credential | LBSW |
| Practice Address |
1547 Parkway Ste 100 Greenwood SC 29646-4081 |
| Mailing Address |
2413 Cedar Spgs S Abbeville SC 29620-6246 |
| Practice Telephone | 8642297120 |
| Mailing Telephone | 8644463407 |
| Enumeration Date | 2008-10-02 |
| Last Update Date | 2008-10-02 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | 421504 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134571730 | Tracey Francine Jackson | Technician, Other | 22764 Normandy Ave, Eastpointe, MI 48021-1854 | 2016-07-07 |
| 1639532765 | Tracey Jackson | Social Worker | 5937 Larchwood Ave, Philadelphia, PA 19143-1115 | 2016-04-05 |
| 1609063882 | Tracey Monique Jackson | Registered Nurse | 23 Flanders St, Rochester, NY 14619-1705 | 2007-10-01 |
| 1174948038 | Tracey Jackson | Occupational Therapist | 4801 Springfield St, Dayton, OH 45431-1084 | 2014-02-28 |
| 1255755930 | Tracey Jackson | Case Manager/Care Coordinator | 820 N Plankinton Ave, Milwaukee, WI 53203-1802 | 2014-02-14 |
| 1487803870 | Tracey D Jackson | Pharmacist | 1000 Locust St, Reno, NV 89502-2597 | 2008-09-10 |
| 1902074545 | Tracey Jackson | Counselor | 2814 W 2nd St, Wilmington, DE 19805-1807 | 2008-02-18 |
| 1215121835 | Tracey Jackson | Physician Assistant | 320 E North Ave, Pittsburgh, PA 15212-4756 | 2007-08-28 |
| 1558486803 | Tracey L Jackson | Counselor | 4612 Roosevelt Ave, Sacramento, CA 95820 | 2007-03-19 |
| 1902808868 | Tracey L Jackson | Nurse Anesthetist, Certified Registered | 615 S New Ballas Rd, Sjmmc Dept of Anes, Saint Louis, MO 63141-8221 | 2005-08-11 |
| Street Address |
1547 PARKWAY STE 100 |
| City | GREENWOOD |
| State | SC |
| Zip Code | 29646-4081 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659562858 | Amy P Loftus | Counselor | 1547 Parkway Ste 100, Greenwood, SC 29646-4081 | 2007-08-05 |
| 1245579846 | Ashlee Nicole Redfern | Counselor | 1547 Parkway Ste 100, Greenwood, SC 29646-4081 | 2013-02-04 |
| 1386993590 | Kayla Shaw | Counselor | 1547 Parkway Ste 100, Greenwood, SC 29646-4081 | 2012-09-04 |
| 1093070351 | Andrew Christopher Emily | Counselor | 1547 Parkway Ste 100, Greenwood, SC 29646 | 2012-07-11 |
| 1770858169 | Colleen E Staton | Counselor | 1547 Parkway Ste 100, Greenwood, SC 29646-4081 | 2012-03-19 |
| 1710255203 | Tracy L Bush | Counselor | 1547 Parkway Ste 100, Greenwood, SC 29646-4081 | 2011-12-12 |
| 1114215514 | Sarah Helen Caldwell | Counselor | 1547 Parkway Ste 100, Greenwood, SC 29646-4081 | 2011-07-19 |
| 1881982544 | Angela Olsen | Counselor | 1547 Parkway Ste 100, Greenwood, SC 29646-4081 | 2011-07-15 |
| 1922329689 | Bonnie S Hasting | Counselor | 1547 Parkway Ste 100, Greenwood, SC 29646-4081 | 2010-06-17 |
| 1679758379 | Drew Hodges Casper | Counselor | 1547 Parkway Ste 100, Greenwood, SC 29646-4081 | 2008-01-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114535416 | Supriya Lal | Dietitian, Registered | 303 Parkwood Rd, Greenwood, SC 29646 | 2020-07-22 |
| 1174158406 | Mara L Schwartz | Registered Nurse | 1226 Spring St., Diabtes Education Department, Greenwood, SC 29646 | 2020-03-06 |
| 1487213724 | Greater Greenwood United Ministry | Family Medicine | 1404 Edgefield Street, Greenwood, SC 29646 | 2019-06-11 |
| 1346747995 | Kelli Diane Clune | Nurse Practitioner | 115 E Alexander Ave, Greenwood, SC 29646 | 2018-04-10 |
| 1184150112 | Sanquinette Sanders Brownlee | Nurse Practitioner | 929 Phoenix Stret, Clinica Gratis, Greenwood, SC 29646 | 2017-05-11 |
| 1194258426 | Kimberley Lovejoy | Assistant Behavior Analyst | 210a Birchtree, Greenwood, SC 29646 | 2017-04-04 |
| 1427590900 | Rejuvenation Massage By Frances | Clinic/Center | 610 Chace Avenue, Greenwood, SC 29646 | 2016-11-15 |
| 1932651643 | Hayley Smith | Counselor | 110 Court Ave W, Greenwood, SC 29646 | 2016-10-28 |
| 1942757927 | Towanda Morton | Community Health Worker | 303 Suite B South Main Street, Greenwood, SC 29646 | 2016-09-07 |
| 1770039976 | Bragan Mace | Pharmacist | 1376 South Main St., Greenwood, SC 29646 | 2016-08-28 |
| Find all providers in zip 29646 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689205437 | Meredith Brown | Counselor | 327 Main St Ste 500, Greenwood, SC 29646-2793 | 2020-01-30 |
| 1053967216 | Yasmine Mcclain | Counselor | 2900 Browning Road 520 Apt 7h, Greenwood, MS 38930-3846 | 2019-08-14 |
| 1073081634 | Rebekah George | Counselor | 105 Howard Rd, Greenwood, IN 46142-3734 | 2018-11-12 |
| 1922583681 | Kaislynn Archie | Counselor | 2504 Browning Road Ext, Greenwood, MS 38930-9417 | 2018-09-28 |
| 1497243653 | Chelsea S Leeds | Counselor | 500 Polk St, Greenwood, IN 46143-1628 | 2018-04-24 |
| 1053826610 | Sarah Malone | Counselor | 2504 Browing Road, Greenwood, MS 38930 | 2017-12-05 |
| 1215464607 | Catherine Johnson | Counselor | 522 West Park Avenue, Greenwood, MS 38930 | 2017-05-16 |
| 1588109672 | Verlyn Lewisboyd | Counselor | 7165 Kimberly Rd, Greenwood, LA 71033-3225 | 2016-12-27 |
| 1962946806 | Katelyn Hunter | Counselor | 48 N Emerson Ave Ste 650, Greenwood, IN 46143-5522 | 2016-12-12 |
| 1982156105 | Candice Due | Counselor | 3786 Harrison Crossing Ln, Greenwood, IN 46142-7616 | 2016-11-04 |
| Find all providers in GREENWOOD | ||||
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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.