MR. JACKIE JEROME JOHNSON SR. (NPI# 1982114344) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1982114344 |
Entity Type | Individual |
Full Name | MR. JACKIE JEROME JOHNSON SR. |
Credential | LCDC-I |
Practice Address |
1715 26th St Lubbock TX 79411-1524 |
Practice Telephone | 8067808300 |
Practice Fax Number | 8067808383 |
Mailing Telephone | 8067808300 |
Mailing Fax Number | 8067808383 |
Enumeration Date | 2017-10-11 |
Last Update Date | 2017-10-11 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
TX | Behavioral Health & Social Service Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1871130112 | Jackie Glen Johnson | Case Management | 434 Ashlawn Dr, Midlothian, TX 76065-5612 | 2019-12-05 |
1770745457 | Jackie Eugene Johnson Sr. | Counselor | 1020 Sw Taylor St Ste 650, Portland, OR 97205-2506 | 2008-06-25 |
1982185021 | Jackie Johnson | Registered Nurse | 4300 Sw 13th St, Gainesville, FL 32608-4006 | 2018-08-27 |
1861940108 | Jackie Johnson | Massage Therapist | 12923 Nw Cornell Rd Ste 201, Portland, OR 97229-5834 | 2016-09-15 |
1740692318 | Jackie Johnson | Behavioral Analyst | 2605 Rainbow Glow St, North Las Vegas, NV 89030-3709 | 2014-05-29 |
1407166119 | Jackie Johnson | Student in an Organized Health Care Education/Training Program | 111 South St., Somerville, MA 02143 | 2010-10-15 |
1740516251 | Jackie Ann Johnson | Licensed Practical Nurse | 627 Smithview Dr, Maryville, TN 37803-6100 | 2009-10-19 |
1679707541 | Jackie H Johnson Jr. | Ophthalmology | 216 Corder Rd, Warner Robins, GA 31088 | 2009-05-07 |
1053320218 | Jackie Ray Johnson | Nurse Anesthetist, Certified Registered | 8200 Walnut Hill Ln, Dallas, TX 75231-4426 | 2006-08-05 |
Street Address |
1715 26TH ST |
City | LUBBOCK |
State | TX |
Zip Code | 79411-1524 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1952813230 | Lacey Johnson | Counselor | 1715 26th St, Lubbock, TX 79411-1524 | 2017-10-26 |
1164933610 | Justine Aleena Vaughn | Counselor | 1715 26th St, Lubbock, TX 79411-1524 | 2017-10-23 |
1295246254 | Dawn Michelle Tousignant | Counselor | 1715 26th St, Lubbock, TX 79411-1524 | 2017-10-18 |
1285144659 | Michelle Renee Luna | Counselor | 1715 26th St, Lubbock, TX 79411-1524 | 2017-10-11 |
1548770910 | Beverly Dell Montgomery | Counselor | 1715 26th St, Lubbock, TX 79411-1524 | 2017-10-11 |
1083124440 | Jordan Santos Conrado Prieto | Counselor | 1715 26th St, Lubbock, TX 79411-1524 | 2017-10-11 |
1619487071 | Tammy Faye Rodriguez | Counselor | 1715 26th St, Lubbock, TX 79411-1524 | 2017-10-11 |
1922518398 | Laura Lea Cross | Counselor | 1715 26th St, Lubbock, TX 79411-1524 | 2017-10-11 |
1184134553 | Wade James Bagley | Counselor | 1715 26th St, Lubbock, TX 79411-1524 | 2017-10-11 |
1912417387 | Holly Kim Warren | Counselor | 1715 26th St, Lubbock, TX 79411-1524 | 2017-10-11 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1720291842 | Robert W.buchanan Dc Pa | Chiropractor | 1807 34th Street, Lubbock, TX 79411 | 2007-05-07 |
1689886319 | City of Lubbock Health Department | Clinical Medical Laboratory | 1902 Texas Ave, Lubbock, TX 79411 | 2007-05-04 |
1104479229 | Heartbeat Midwifery Pllc | Clinic/Center | 2409 20th St, Lubbock, TX 79411-1003 | 2019-07-17 |
1932448230 | Trisha Kay Green | Occupational Therapist | 2401 20th St, Lubbock, TX 79411-1003 | 2013-02-06 |
1033450226 | Morgan Rees | Occupational Therapist | 2401 20th St, Lubbock, TX 79411-1003 | 2013-03-13 |
1639419096 | Aileen Tan | Occupational Therapist | 2401 20th St, Lubbock, TX 79411-1003 | 2013-02-21 |
1255874749 | Marcos Junior Vallejo | Specialist/Technologist | 2418 22nd St, Lubbock, TX 79411-1010 | 2016-12-01 |
1962618702 | Sara Elizabeth Blakeslee | Marriage & Family Therapist | 2214 21st St Apt A, Lubbock, TX 79411-1137 | 2007-05-16 |
1356364814 | Maribeth Dennis | Counselor | 2421 27th St, Lubbock, TX 79411-1301 | 2006-07-25 |
1790805075 | Sue Key Sanders | Counselor | 2429 28th St, Lubbock, TX 79411-1305 | 2007-03-30 |
Find all providers in zip 79411 |
Taxonomy Code | 101YA0400X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Counselor |
Specialization | Addiction (Substance Use Disorder) |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1881209633 | Latia Green Scherpereel | Counselor | 4204 49th St, Lubbock, TX 79413-3722 | 2020-09-09 |
1851861439 | Zachery Brian Sneed | Counselor | 3b310, 3601 4th St Stop 6225, Lubbock, TX 79430 | 2018-11-27 |
1447762414 | Diana L. Lorber | Counselor | 4913 S Loop 289, Lubbock, TX 79424-1630 | 2017-10-31 |
1881065100 | Billy Don Huey | Counselor | 1804 E 2nd St, Lubbock, TX 79403-4016 | 2015-10-13 |
1396111977 | Jessica Ann Murphy | Counselor | 2325 93rd Pl, Lubbock, TX 79423-4423 | 2015-08-18 |
1114287992 | John Allen Shiflet | Counselor | 1709 N Fm 179, Lubbock, TX 79416 | 2012-05-25 |
1659668481 | William Harris | Counselor | 1705 N. Fm. 179, Lubbock, TX 79416 | 2011-06-30 |
1508152901 | Lilian Francisca Hayes | Counselor | 2345 50th St., Lubbock, TX 79412 | 2011-06-23 |
1215222633 | Casey Wilson | Counselor | 1705 N. Fm 179, Lubbock, TX 79416 | 2011-06-14 |
1861787285 | Sarah Delacruz | Counselor | 2345 50th Street, Lubbock, TX 79412 | 2011-06-14 |
Find all providers in LUBBOCK |
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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.