Christian Nicole Record-jackson, PSY 0810008030 is a medicare enrolled "Psychologist - Clinical" provider in Jb Andrews, Maryland. Her current practice location is
1060 W Perimeter Rd, Jb Andrews, Maryland. You can reach out to her office (for appointments etc.) via phone at
(240) 857-7186.
Christian Nicole Record-jackson is licensed to practice in Virginia (license number 0810008030) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1407344518.
Healthcare Provider's Profile
Full Name | Christian Nicole Record-jackson |
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Gender | Female |
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Speciality | Psychologist - Clinical |
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Location | 1060 W Perimeter Rd, Jb Andrews, Maryland |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1407344518
- Provider Enumeration Date: 04/24/2018
- Last Update Date: 07/09/2024
Medicare PECOS Information:
- PECOS PAC ID: 5193261204
- Enrollment ID: I20240725001587
Medical Identifiers
Medical identifiers for Christian Nicole Record-jackson such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1407344518 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101YP2500X | Counselor - Professional | 105956 (California) | Secondary |
103TC0700X | Psychologist - Clinical | 0810008030 (Virginia) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Christian Nicole Record-jackson is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Christian Nicole Record-jackson, PSY 0810008030 3905 26th St, Chesapeake Beach, MD 20732-9383 Ph: (831) 239-8364 | Christian Nicole Record-jackson, PSY 0810008030 1060 W Perimeter Rd, Jb Andrews, MD 20762-6602 Ph: (240) 857-7186 |
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