SHIRRON GARDNER-JACKSON LCDCIII NPI 1548701170

NPI Information

  • NPI: 1548701170
  • Provider Name: SHIRRON GARDNER-JACKSON, LCDCIII
  • Classification: Counselor - 101YA0400X
  • Specialization: Addiction (Substance Use Disorder)
  • Entity Type: Individual
  • Address: 4660 ROBERTS RD
    COLUMBUS, OH
    ZIP 43228
  • Phone: (513) 834-7063

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NPI Details

Shirron Gardner-jackson, LCDCIII is an addiction (substance use disorder) counselor in Columbus, OH. Shirron Gardner-jackson, LCDCIII NPI is 1548701170. 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:

4660 ROBERTS RD
COLUMBUS, OH
ZIP 43228-671
Phone: (513) 834-7063
Fax: (513) 873-1567

The enumeration date for this NPI number is 3/15/2017 and was last updated on 11/13/2019.

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)LCDCIII.141283OHIOYes
2101YM0800XCounselorMental HealthLCDCIII.141283OHIONo

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

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