MR. JOSEPH RAY JACKSON M.A. NPI 1689011983

NPI Information

NPI: 1689011983
Provider Name: MR. JOSEPH RAY JACKSON, M.A.
Classification: Counselor - 101YA0400X
Entity Type: Individual

Specialization: Addiction (Substance Use Disorder)

Address:
12 N 64TH ST
BELLEVILLE, IL
ZIP 62223
Phone: (618) 397-0900
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MR. Joseph Ray Jackson, M.A. is an addiction (substance use disorder) counselor in Belleville, IL. MR. Joseph Ray Jackson, M.A. NPI is 1689011983. 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:

12 N 64TH ST
BELLEVILLE, IL
ZIP 62223-809
Phone: (618) 397-0900

The enumeration date for this NPI number is 5/28/2013 and was last updated on 5/28/2013.

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	101YA0400X	Counselor	Addiction (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: 11/14/2023

NPI Synchronization or Removal

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