JOANNE KELLY JACKSON B.AB.A.CADC 1 NPI 1417074675

NPI Information

  • NPI: 1417074675
  • Provider Name: JOANNE KELLY JACKSON, B.A,B.A.,CADC 1
  • Classification: Counselor - 101YA0400X
  • Specialization: Addiction (Substance Use Disorder)
  • Entity Type: Individual
  • Address: 205 SE 3RD AVE
    HILLSBORO, OR
    ZIP 97123
  • Phone: (503) 693-3104

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NPI Details

Joanne Kelly Jackson, B.A,B.A.,CADC 1 is an addiction (substance use disorder) counselor in Hillsboro, OR. Joanne Kelly Jackson, B.A,B.A.,CADC 1 NPI is 1417074675. 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:

205 SE 3RD AVE
HILLSBORO, OR
ZIP 97123-093
Phone: (503) 693-3104

The enumeration date for this NPI number is 3/23/2007 and was last updated on 3/7/2008.

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
1101YA0400XCounselorAddiction (Substance Use Disorder)Yes

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: 3/30/2025

NPI Synchronization or Removal

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