TEANA JACKSON (NPI# 1912479098) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912479098 |
| Entity Type | Individual |
| Full Name | TEANA JACKSON |
| Practice Address |
8407 S Constance Ave Chicago IL 60617-2218 |
| Mailing Address |
Po Box 378401 Chicago IL 60637-8401 |
| Practice Telephone | 3127212471 |
| Enumeration Date | 2018-12-29 |
| Last Update Date | 2018-12-29 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| Street Address |
8407 S CONSTANCE AVE |
| City | CHICAGO |
| State | IL |
| Zip Code | 60617-2218 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104227313 | Sandra Hunter Bass | Social Worker | 8407 S Constance Ave, Chicago, IL 60617-2218 | 2014-09-07 |
| 1033716691 | Maisha Starks | Counselor | 8407 S Constance Ave, Chicago, IL 60617-2218 | 2020-10-07 |
| 1750909198 | Sharon Clark | Counselor | 8407 S Constance Ave, Chicago, IL 60617-2218 | 2020-07-13 |
| 1326664079 | David Wilson | Counselor | 8407 S Constance Ave, Chicago, IL 60617-2218 | 2020-06-18 |
| 1396390936 | Tierra Ellis | Counselor | 8407 S Constance Ave, Chicago, IL 60617-2218 | 2019-08-08 |
| 1386202562 | Paris Smith | Counselor | 8407 S Constance Ave, Chicago, IL 60617-2218 | 2019-06-03 |
| 1467010678 | Sherese Johnson | Counselor | 8407 S Constance Ave, Chicago, IL 60617-2218 | 2019-06-03 |
| 1659855807 | Stacia Jones | Counselor | 8407 S Constance Ave, Chicago, IL 60617-2218 | 2018-09-23 |
| 1679094569 | Arnetha Gholston | Case Manager/Care Coordinator | 8407 S Constance Ave, Chicago, IL 60617-2218 | 2017-06-29 |
| 1437532694 | Resk Residential Services Inc | Social Worker | 8407 S Constance Ave, Chicago, IL 60617-2218 | 2015-07-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871102921 | Manuel Lule | Physical Therapy Assistant | 9535 S Jeffery Boulevard, Chicago, IL 60617 | 2020-07-24 |
| 1083253546 | Vanaja Thotten | Internal Medicine | 8012 S.crandon Ave, Chicago, IL 60617 | 2020-01-02 |
| 1427527365 | Stony Island Dental PC | Dentist | 1600 E 93rd Street, Chicago, IL 60617 | 2018-11-21 |
| 1871060301 | Tamika Nicole Whitehead | Social Worker | 2822 East 83rd Street, Chicago, IL 60617 | 2018-11-02 |
| 1528543774 | Felicia Nwankwo | Nurse Practitioner | 2822 E 83rd Street Bradond Famiy Health Cener, Chicago, IL 60617 | 2018-10-03 |
| 1972099307 | David Phan | Optometrist | 1753 E 95th St Ste B-100, Chicago, IL 60617 | 2018-07-09 |
| 1831607340 | Pamela Evette Ewing | Counselor | 9145 S. Merrill Ave, Chicago, IL 60617 | 2018-01-18 |
| 1366976631 | Ali Mostafa Serhal | Radiology | 240 E. Huron St, Suite 1-203, Chicago, IL 60617 | 2017-04-13 |
| 1447784921 | 1915-25 95th St., LLC | Clinic/Center | 1915 E 95th St, Chicago, IL 60617 | 2017-04-12 |
| 1881140408 | Yeferson Laverde | Social Worker | 3062 East 31st, Chicago, IL 60617 | 2016-09-01 |
| Find all providers in zip 60617 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730780602 | Saba Aqel | Counselor | 107 W Van Buren St Ste 215, Chicago, IL 60605-1054 | 2020-11-05 |
| 1538768155 | Angelicare LLC | Counselor | 6650 N Northwest Hwy Ste 215, Chicago, IL 60631-1363 | 2020-10-23 |
| 1013516145 | Modern Soul Therapy LLC | Counselor | 2000 N Racine Ave Ste 2160, Chicago, IL 60614-4045 | 2020-10-20 |
| 1477151942 | Mansukh Sandhu | Counselor | 8765 W Higgins Rd Ste 450, Chicago, IL 60631-4172 | 2020-10-15 |
| 1881291920 | Freddy Reyes | Counselor | 931 W Leland Ave Apt 405, Chicago, IL 60640-6611 | 2020-10-01 |
| 1508463704 | Tynisha Jointer | Counselor | 7710 S Saint Lawrence Ave, Chicago, IL 60619-2925 | 2020-10-01 |
| 1851908206 | Manqual Chambers | Counselor | 2801 S King Dr, Chicago, IL 60616-2949 | 2020-09-29 |
| 1184231672 | Francesca Cottone | Counselor | 1616 N Nordica Ave, Chicago, IL 60707-4317 | 2020-09-28 |
| 1952916322 | Elle Skelton | Counselor | 2219 N Seeley Ave Apt 3f, Chicago, IL 60647-3363 | 2020-09-13 |
| 1437764305 | Donita M Lester | Counselor | 7022 S South Shore Dr Apt 214, Chicago, IL 60649-2229 | 2020-09-09 |
| Find all providers in CHICAGO | ||||
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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.