CHARMAYNE LATRIECE JACKSON (NPI# 1922564012) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922564012 |
| Entity Type | Individual |
| Full Name | CHARMAYNE LATRIECE JACKSON |
| Credential | MS |
| Practice Address |
2601 Nw 23rd Blvd Apt 243 Gainesville FL 32605-5958 |
| Mailing Address |
3207 Acklen Dr Sw Apt C1 Huntsville AL 35805-4353 |
| Practice Telephone | 3176982713 |
| Mailing Telephone | 3176982713 |
| Enumeration Date | 2019-02-14 |
| Last Update Date | 2019-02-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | Behavioral Health & Social Service Providers |
| Street Address |
2601 NW 23RD BLVD APT 243 |
| City | GAINESVILLE |
| State | FL |
| Zip Code | 32605-5958 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780205435 | Remy Fadel | Student in an Organized Health Care Education/Training Program | 1147 Nw 64th Terr, Gainsville, FL 32605 | 2020-05-05 |
| 1518528652 | Family Restoration Station Counseling Center, LLC | Marriage & Family Therapist | 912 Nw 56th Terr, Suite A, Gainesville, FL 32605 | 2019-06-27 |
| 1568925105 | Ryeisha Hough | Behavior Technician | 1051 Sw 56 Terrace, Gainesville, FL 32605 | 2019-04-10 |
| 1003308040 | Titan Mri LLC | Clinic/Center | 919 Nw 57th St Ste 20, Gainesville, FL 32605 | 2018-06-05 |
| 1922598432 | Angela Maria Fernandez Manovel | Student in an Organized Health Care Education/Training Program | 1147 Nw 64th Terrace, Gainesville, FL 32605 | 2018-05-10 |
| 1396235800 | Aya Marachi | Student in an Organized Health Care Education/Training Program | 6500 W. Newberry Rd., Gainesville, FL 32605 | 2018-05-10 |
| 1053813543 | Jaime L Jasser | Counselor | 2240 Nw 40th Terrace Ste A, Gainesville, FL 32605 | 2018-03-01 |
| 1164932901 | Anesthesia Physician Solutions of North Florida, LLC | Anesthesiology | 6500 W Newberry Road, Gainesville, FL 32605 | 2017-10-06 |
| 1336667930 | Zina Theresse Durr | Adult Companion | 3124 Nw 29th Place, Gainesville, FL 32605 | 2017-09-03 |
| 1982126306 | Crystal Thompson Baumann | Nurse Practitioner | 6440 W Newberry Rd Ste 409, Gainesville, FL 32605 | 2017-07-07 |
| Find all providers in zip 32605 | ||||
| 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 |
|---|---|---|---|---|
| 1477113140 | Catlin Cade Bauer | Counselor | 4421 Nw 39th Ave Ste 3, Gainesville, FL 32606-7221 | 2019-06-16 |
| 1861050247 | Timothy Tackett | Counselor | 4300 Sw 13th St # 2, Gainesville, FL 32608-4006 | 2019-05-31 |
| 1134785934 | Connecting The Dots Services, LLC | Counselor | 901 Nw 8th Ave Ste C18, Gainesville, FL 32601-5089 | 2019-05-16 |
| 1407343932 | Michelle Lynn Tanner | Counselor | 7450 Heritage Village Plz Unit 101, Gainesville, VA 20155-3091 | 2018-04-19 |
| 1770093320 | Daniel Mcpherson | Counselor | 4703 Nw 53rd Ave., Suite A-2, Gainesville, FL 32653 | 2017-10-10 |
| 1255860193 | Debra Lynn Weiss Hatfield | Counselor | 2240 Nw 40th Ter Ste A, Gainesville, FL 32605-3590 | 2017-06-05 |
| 1558807701 | Tamara Mckenzie | Counselor | 4300 Sw13th St, Gainesville, FL 32608-4006 | 2017-01-12 |
| 1245776616 | Izerial Toles | Counselor | 324 S Lindsay St, Gainesville, TX 76240-4834 | 2017-01-10 |
| 1306392352 | Brooke Schultz | Counselor | 4400 Sw 13th Street, Gainesville, FL 32608 | 2016-08-30 |
| 1760839534 | Nancy Christiana Collins | Counselor | 4907 Nw 43rd St C., Gainesville, FL 32606 | 2016-05-20 |
| Find all providers in GAINESVILLE | ||||
| City | GAINESVILLE |
| Zip Code | 32605 |
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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.