Christian Nicole Record-jackson, PSY 0810008030 is a
Psychologist - Clinical based in Jb Andrews, Maryland. Christian Nicole Record-jackson is licensed to practice in Virginia (license number 0810008030) and her current practice location is
1060 W Perimeter Rd, Jb Andrews, Maryland. She can be reached at her office (for appointments etc.) via phone at
(240) 857-7186.
NPI number for Christian Nicole Record-jackson is 1407344518 and her current mailing address is 3905 26th St, Chesapeake Beach, Maryland. She
does not participate in medicare program and thus does not accept medicare assignments. 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 | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1407344518
- Provider Enumeration Date: 04/24/2018
- Last Update Date: 07/09/2024
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
NOT enrolled with medicare and thus cannot 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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