MR. DARRELL M JACKSON NPI 1417035825

NPI Information

NPI: 1417035825
Provider Name: MR. DARRELL M JACKSON
Classification: Counselor - 101Y00000X
Entity Type: Individual
Address:
2336 GODDARD PARKWAY
SALISBURY, MD
ZIP 21801
Phone: (410) 334-6961
Get Directions

MR. Darrell M Jackson is a counselor in Salisbury, MD. The provider is a provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification. MR. Darrell M Jackson NPI is 1417035825. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2336 GODDARD PARKWAY
SALISBURY, MD
ZIP 21801
Phone: (410) 334-6961
Fax: (410) 334-6960

The enumeration date for this NPI number is 11/2/2006 and was last updated on 9/18/2008.

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	101Y00000X	Counselor				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	742L	MEDICARE ID-TYPE UNSPECIFIED	MARYLAND
2	609500303	MEDICAID	MARYLAND
3	609500300	MEDICAID	MARYLAND
4	LM49EA	OTHER	MARYLAND	CAREFIRST BCBS GROUP
5	259147000	OTHER	MARYLAND	MAGELLAN GROUP
6	517251	OTHER		UHC MAMSI GROUP
7	609550004	MEDICAID	MARYLAND
8	609550001	MEDICAID	MARYLAND
9	R968	OTHER	DISTRICT OF COLUMBIA	CAREFIRST BCBS GROUP

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »