PRINCESS JACKSON (NPI# 1952748907) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952748907 |
| Entity Type | Individual |
| Full Name | PRINCESS JACKSON |
| Practice Address |
284 Executive Park Dr Suite 100 Concord NC 28025-1831 |
| Practice Telephone | 7049391100 |
| Practice Fax Number | 7049391173 |
| Mailing Telephone | 7049391100 |
| Mailing Fax Number | 7049391173 |
| Enumeration Date | 2013-05-31 |
| Last Update Date | 2013-05-31 |
| 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 |
284 EXECUTIVE PARK DR SUITE 100 |
| City | CONCORD |
| State | NC |
| Zip Code | 28025-1831 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326030792 | Lacy Henry Miller | Nurse Practitioner | 284 Executive Park Dr, Concord, NC 28025-1831 | 2005-08-22 |
| 1326502204 | Tiffany Robinson Hooker | Counselor | 284 Executive Park Dr, Concord, NC 28025-1831 | 2019-01-25 |
| 1710464961 | Christine Ann Still | Social Worker | 284 Executive Park Dr, Concord, NC 28025-1831 | 2018-07-20 |
| 1457838732 | Justine Mohre | Social Worker | 284 Executive Park Dr, Concord, NC 28025-1831 | 2018-07-19 |
| 1821598608 | Holly Hall Hatley | Licensed Practical Nurse | 284 Executive Park Dr, Concord, NC 28025-1831 | 2018-02-18 |
| 1063946432 | Lisa Crowder | Licensed Practical Nurse | 284 Executive Park Dr, Ste 100, Concord, NC 28025-1831 | 2017-04-12 |
| 1215474267 | Julia Bentley | Counselor | 284 Executive Park Dr, Concord, NC 28025-1831 | 2017-01-30 |
| 1760929798 | Richard Moore | Counselor | 284 Executive Park Dr, Suite100, Concord, NC 28025-1894 | 2017-01-29 |
| 1760928352 | Latehia Cade | Licensed Practical Nurse | 284 Executive Park Dr, Ste 100, Concord, NC 28025-1831 | 2017-01-06 |
| 1811432818 | Tiffany Moss | Counselor | 284 Executive Park Dr, Ste 100, Concord, NC 28025-1831 | 2016-12-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053910729 | Renewed Mindset Therapeutic Services, Pllc | Social Worker | 349 Copperfield Blvd Suite L #334, Concord, NC 28025 | 2020-10-22 |
| 1194284380 | Carolinas Physicians Network Inc | Internal Medicine | 610 Alfred Brown Jr. Court, Concord, NC 28025 | 2019-03-18 |
| 1164913596 | Damarius Raymond Faggart | Counselor | 503 Amhurst Drive, Concord, NC 28025 | 2018-05-22 |
| 1437677085 | Kathryn Emily Kanauer | Counselor | 280 Executive Park Dr Ne, Concord, NC 28025 | 2017-09-05 |
| 1649794439 | Foster Health & Homecare, LLC | Home Health | 363 Church Street North, Suite 260-i, Concord, NC 28025 | 2017-08-02 |
| 1326569336 | Jessie Leigh Tilley-compton | Social Worker | 371 Amhurst St Sw, Concord, NC 28025 | 2017-06-29 |
| 1609305663 | Sarah Katherine Thompson | Licensed Practical Nurse | 248 Executive Park Dr, Concord, NC 28025 | 2017-06-05 |
| 1023463098 | Kiera Brown | Social Worker | 219 Lephillip Court, Concord, NC 28025 | 2016-04-27 |
| 1992169445 | Brittiny N. Ingram Vanterpool | Counselor | 250 Branchview Dr Sw, Concord, NC 28025 | 2016-04-11 |
| 1215399852 | The Charlotte-mecklenburg Hospital Authority | Clinic/Center | 840 Warren C. Coleman Blvd, Concord, NC 28025 | 2016-03-23 |
| Find all providers in zip 28025 | ||||
| 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 |
|---|---|---|---|---|
| 1841805967 | Parisa Zamanian | Counselor | 2118 Willow Pass Rd # 500, Concord, CA 94520-2408 | 2020-09-15 |
| 1295371359 | Colette Elaine Trotter | Counselor | 2931 Prospect St, Concord, CA 94518-1025 | 2019-11-25 |
| 1093350506 | Faith Speaks | Counselor | 730 Cheswick Ave, Concord, NC 28025-7079 | 2019-11-08 |
| 1073098026 | Kristen Kenney | Counselor | 236 Partridge Ln, Concord, MA 01742-2651 | 2018-09-26 |
| 1164913596 | Damarius Raymond Faggart | Counselor | 503 Amhurst Drive, Concord, NC 28025 | 2018-05-22 |
| 1568959625 | Laurie Ford | Counselor | 705 Samuel Adams Cir Sw, Concord, NC 28027 | 2018-04-15 |
| 1831616663 | Kelsey Carey | Counselor | 700 Church St N Ste 70, Concord, NC 28025-4380 | 2017-08-23 |
| 1962947473 | Nathan Ryan Evans | Counselor | 1030 Central Dr Nw, Concord, NC 28027-4296 | 2016-12-20 |
| 1255882684 | Stephanie Randazzo | Counselor | 20 Nathan Pratt Drive Unit 209, Concord, MA 01742 | 2016-10-20 |
| 1164871356 | Sokcheat Son | Counselor | 2118 Willow Pass Road, Ste 500, Concord, CA 94520 | 2016-06-08 |
| Find all providers in CONCORD | ||||
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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.