MS. DOREEN J. JACKSON LMHC NPI 1235229063

NPI Information

NPI: 1235229063
Provider Name: MS. DOREEN J. JACKSON, LMHC
Classification: Counselor - 101YM0800X
Entity Type: Individual

Specialization: Mental Health

Address:
40 ALMON AVE
BROCKTON, MA
ZIP 02301
Phone: (508) 580-8794
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MS. Doreen J. Jackson, LMHC is a mental health counselor in Brockton, MA. MS. Doreen J. Jackson, LMHC NPI is 1235229063. 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:

40 ALMON AVE
BROCKTON, MA
ZIP 02301-515
Phone: (508) 580-8794
Fax: (508) 580-1668

The enumeration date for this NPI number is 10/13/2006 and was last updated on 7/8/2007.

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	3183	MASSACHUSETTS	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	21189788924 01	OTHER	MASSACHUSETTS	BEECH ST.
2	1029820	OTHER	MASSACHUSETTS	NEIGHBORHOOD HEALTH PLAN
3	LM0383	OTHER	MASSACHUSETTS	BLUE CROSS BLUE SHIELD MA
4	1898035	MEDICAID	MASSACHUSETTS
5	343393	OTHER	MASSACHUSETTS	MAGELLAN
6	1898035	OTHER	MASSACHUSETTS	MASS BEHAVIORAL HEALTH PL
7	411270	OTHER	MASSACHUSETTS	HARVARD PILGRIM
8	1898035	OTHER	MASSACHUSETTS	MBHP
9	87149	OTHER	MASSACHUSETTS	UNITED BEHAVIORAL HEALTH
10	87149	OTHER	MASSACHUSETTS	UNITED HEALTHCARE

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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