COURTNEY JACKSON (NPI# 1992352421) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1992352421 |
Entity Type | Individual |
Full Name | COURTNEY JACKSON |
Practice Address |
250 Georgia Ave Se Suite 206 Atlanta GA 30312 |
Practice Telephone | 2024413364 |
Enumeration Date | 2019-08-20 |
Last Update Date | 2019-08-20 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 175T00000X | Peer Specialist | GA | Other Service Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1891394938 | Courtney Jackson | Technician | 497 Candlestick Ct Apt B, Galloway, OH 43119-9216 | 2020-10-20 |
1063024842 | Courtney Ann Jackson | Technician | 5001 Mcclellan Hwy, Branchland, WV 25506-7704 | 2020-08-21 |
1912318429 | Courtney Jackson | Technician | 4134 Woodmont Dr, Houston, TX 77045-3330 | 2014-05-19 |
1760814396 | Courtney Danielle Jackson | Counselor | 534 E Basin St, Norristown, PA 19401-4068 | 2013-08-06 |
1487930723 | Courtney Jackson | Specialist/Technologist | 19424 Fallow Ln, Edinburg, TX 78542-1038 | 2011-11-01 |
1689824302 | Courtney Brooke Jackson | Naturopath | 511 Sw 10th Ave Ste 801, Portland, OR 97205-2709 | 2008-09-30 |
1063606846 | Courtney Lara Jackson | Counselor | 1801 Vincente St, San Francisco, CA 94116-2923 | 2007-09-05 |
1164029245 | Courtney Jackson | Speech-Language Pathologist | 65 Court St, Brooklyn, NY 11201-4916 | 2020-10-02 |
1457966509 | Courtney Tamara Jackson | Nurse Practitioner | 407 Cowart Ave, Valdosta, GA 31602-2635 | 2020-09-14 |
1013533926 | Courtney Marie Jackson | Family Medicine | 750 Broadway Ste 350, Fort Wayne, IN 46802-1412 | 2020-06-17 |
Street Address |
250 GEORGIA AVE SE SUITE 206 |
City | ATLANTA |
State | GA |
Zip Code | 30312 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1316015969 | Kenika Holloway | Counselor | 250 Georgia Ave Se, Suite #206, Atlanta, GA 30312-3046 | 2006-12-01 |
1144786161 | Danita Clark | Speech-Language Pathologist | 250 Georgia Ave Se, Atlanta, GA 30312-3046 | 2019-02-14 |
1396232971 | Carrol Bigby | Registered Nurse | 250 Georgia Ave Se, Atlanta, GA 30312-3046 | 2018-04-18 |
1780196808 | Charmaine Bell | Social Worker | 250 Georgia Ave Se, Atlanta, GA 30312-3046 | 2017-10-30 |
1811412752 | Ashlee Sledge | Counselor | 250 Georgia Ave Se, Atlanta, GA 30312-3046 | 2017-08-11 |
1568903466 | Dawn Townsend | Counselor | 250 Georgia Ave Se, Suite 206, Atlanta, GA 30312-3046 | 2017-03-13 |
1902346638 | Ykindalyn Mitchell | Counselor | 250 Georgia Ave Se, Suite 206, Atlanta, GA 30312-3046 | 2017-02-28 |
1366980955 | Khatonya Clemons | Counselor | 250 Georgia Ave Se, Atlanta, GA 30312-3046 | 2017-02-03 |
1730557919 | Counseling and Psychological Services - Atlanta | Psychologist | 250 Georgia Ave Se, Suite 205, Atlanta, GA 30312-3046 | 2015-09-04 |
1912314246 | Carson Community Counseling & Chaplain Services, LLC | Community/Behavioral Health | 250 Georgia Ave Se, Atlanta, GA 30312-3046 | 2014-07-18 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1770108516 | Bita Ranjbari | Physician Assistant | 659 Auburn Ave Se, Suite 505, Atlanta, GA 30312 | 2020-06-08 |
1609439629 | Adeyinka Edward Adeniyi | Student in an Organized Health Care Education/Training Program | Wellstar Atlanta Medical Center, 303 Parkway Drive Ne, 4th Floor, Internal Medicine Department, Atlanta, GA 30312 | 2019-04-16 |
1003378670 | James Spratt IIi | Student in an Organized Health Care Education/Training Program | 303 Parkway Drive, Ne, 4th Floor, Wellstar Atlanta Medical Center Department of Orthopaed, Atlanta, GA 30312 | 2019-04-03 |
1659833440 | Derrick Edward Wendler | Student in an Organized Health Care Education/Training Program | Wellstar Atlanta Medical Center Dpt of Orthopaedics, 303 Parkway Drive Ne, 4th Floor, Atlanta, GA 30312 | 2019-04-02 |
1336631266 | The Atlanta Small Business Training Consortium, Inc. | Local Education Agency (LEA) | 250 Georgia Ave Se Ste 207a, Atlanta, GA 30312 | 2018-06-06 |
1669960134 | Derek Mccranie | Student in an Organized Health Care Education/Training Program | 303 Parkway Drive, Atlanta, FL 30312 | 2018-04-30 |
1336646223 | Amy Ruth Williams | Nurse Practitioner | 383 Ralph Mcgill Blvd Ne Apt D, Atlanta, GA 30312 | 2018-04-09 |
1730689183 | Lisa Marie Margavage | Chiropractor | 720 Ralph Mcgill Blvd Ne Unit 210, Atlanta, GA 30312 | 2018-02-12 |
1922518836 | Rodney Aldridge | Registered Nurse | 250 Georgia Avenue, Suite 206, Atlanta, GA 30312 | 2017-10-05 |
1629599279 | Huda Hashim Elsamani Elsheikh | Student in an Organized Health Care Education/Training Program | 303 Parkway Dr Ne, Wellstar Atlanta Medical Center, Dept of Graduate Medical Education, Internal Medicine, Atlanta, GA 30312 | 2017-07-05 |
Find all providers in zip 30312 |
Taxonomy Code | 175T00000X |
Grouping | Other Service Providers |
Classification | Peer Specialist |
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. |
Notes: Source: National Uniform Claim Committee [7/1/2014: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1386195774 | Scott Kerns Jr. | Peer Specialist | 433 Highland Ave Ne, Apt 1156, Atlanta, GA 30312-1391 | 2016-10-20 |
1982203311 | The Recovery Coach, LLC | Peer Specialist | 6100 Lake Forrest Dr Ste 450, Atlanta, GA 30328-3837 | 2020-10-17 |
1326515040 | Michael Lamont Osborne | Peer Specialist | 5680 Fulton Industrial Blvd Sw, Atlanta, GA 30336-2659 | 2018-10-31 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1538760103 | Green Zone Counseling | Peer Specialist | 432 Canton Rd Ste G, Cumming, GA 30040-2000 | 2020-11-02 |
1225678386 | John William Burdeshaw | Peer Specialist | 3916 Valley Rd, Columbus, GA 31907-5657 | 2020-01-07 |
1851953962 | Jamie Greshawn Hudgens | Peer Specialist | 1734 Ridge Ct Se, Conyers, GA 30013-1726 | 2019-06-28 |
1497213748 | Ronald E. Johnson | Peer Specialist | Carl Vinson Va Medical Center, 1826 Veterans Blvd., Dublin, GA 31021 | 2019-03-06 |
1669941761 | Paul-david Arthur Cooper | Peer Specialist | 117 Shawnee Street, Va Savannah Clinic, Savannah, GA 31419 | 2018-11-19 |
1477069292 | Penny Campbell Foskey | Peer Specialist | 2041 W Elm St, Wrightsville, GA 31096-5156 | 2017-12-15 |
1568913945 | Michelle Little | Peer Specialist | 6828 Sarah Jane Ln, Riverdale, GA 30296-2600 | 2016-10-20 |
1558713479 | Safe Place Atlanta | Peer Specialist | 6612 Pamplona Pl, College Park, GA 30349-8491 | 2016-07-02 |
1194196329 | Mary Williams | Peer Specialist | 277 E Big Indian Trl Ne, Rome, GA 30165-7413 | 2015-10-14 |
1750771531 | Michael O'bannon | Peer Specialist | 3708 Chinaberry Ln, Snellville, GA 30039-4053 | 2015-01-30 |
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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.