GAIL E JACKSON LISW NPI 1104817303

NPI Information

NPI: 1104817303
Provider Name: GAIL E JACKSON, LISW
Classification: Counselor - 101YM0800X
Entity Type: Individual

Specialization: Mental Health

Address:
625 TRUMAN ST NE
ALBUQUERQUE, NM
ZIP 87110
Phone: (505) 272-6916
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Gail E Jackson, LISW is a mental health counselor in Albuquerque, NM. Gail E Jackson, LISW NPI is 1104817303. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

625 TRUMAN ST NE
ALBUQUERQUE, NM
ZIP 87110-443
Phone: (505) 272-6916

The enumeration date for this NPI number is 11/4/2005 and was last updated on 7/9/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YM0800X	Counselor	Mental Health	I-0090	NEW MEXICO	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	80529275	MEDICAID	NEW MEXICO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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