Keandrea Jackson in Cleveland - Mental Health
Keandrea Jackson - NPI 1639353592
Keandrea Jackson is a Mental Health in Cleveland, Mississippi. Keandrea Jackson practices all healthcare services and medical treatments related to Mental Health. The NPI Number for Keandrea Jackson is 1639353592. The last update date is 2021-07-09.
Keandrea Jackson's current location address is 113a S Davis Ave, Cleveland, Mississippi. You can contact this provider via phone number 6628439445 and fax number 6628439447. The mailing address for Keandrea Jackson is 113a S Davis Ave, Cleveland, Mississippi. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Keandrea Jackson |
|---|---|
| Address | 113a S Davis Ave, Cleveland, Mississippi |
| Phone Number | 6628439445 |
| Fax Number | 6628439447 |
| Sole Proprietor | N |
| Credentials | M.A. |
NPI Number Detail
| NPI Number | 1639353592 |
|---|---|
| Provider Enumeration Date | 2007-12-27 |
| Last Updated Date | 2021-07-09 |
Provider Mailing Address Detail
| Address | 113a S Davis Ave |
|---|---|
| City | Cleveland |
| State | Mississippi (MS) |
| Post Code | 387323447 |
| Phone Number | 6628439445 |
| Fax Number | 6628439447 |
Provider's Primary Taxonomy Detail
| Speciality | Mental Health |
|---|---|
| Taxonomy | 101Ym0800X |
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Definition: A counselor who helps people manage conditions like depression, anxiety, grief, relationship issues, and more. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1670076 | MS | -- |
Post Comment/ Review Below
What is the unique 10-digit identifier code assigned to Keandrea Jackson by the Centers for Medicare & Medicaid Services?
The Keandrea Jackson has been issued the NPI (National Provider Identifier) 1639353592 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Could you share the physical location details of Keandrea Jackson?
The Keandrea Jackson is situated at 113A S Davis Ave, in the city of Cleveland, state of MS, with the zip code 387323447.
What is Keandrea Jackson's primary field of medical specialization, and what is the corresponding taxonomy classification code for this area of expertise?
The primary field of medical specialization for Keandrea Jackson is Mental Health, and the taxonomy classification code that categorizes this area of expertise is 101Ym0800X.
On what date did the Centers for Medicare & Medicaid Services issue the 1639353592 to Keandrea Jackson?
The Keandrea Jackson received its 1639353592 assignment from the Centers for Medicare & Medicaid Services on 2007-12-27.
When was the information pertaining to Keandrea Jackson most recently updated or revised?
The details related to Keandrea Jackson, including its address, specialty, and other relevant information, were last updated or revised on 2021-07-09.
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