| Mr Jaissen M Jackson, | |
|
194 Webster Ave, Providence, RI 02909-3818 | |
| (401) 261-0321 | |
| Not Available |
| Full Name | Mr Jaissen M Jackson |
|---|---|
| Gender | Male |
| Speciality | Counselor - Mental Health |
| Location | 194 Webster Ave, Providence, Rhode Island |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275074171 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Secondary |
| 101YM0800X | Counselor - Mental Health | MHC01094 (Rhode Island) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Jaissen M Jackson, 530 N Main St, Providence, RI 02904-5762 Ph: (401) 276-4100 | Mr Jaissen M Jackson, 194 Webster Ave, Providence, RI 02909-3818 Ph: (401) 261-0321 |
Olivia Meunier, MA Counselor Medicare: Not Enrolled in Medicare Practice Location: 530 N Main St, Providence, RI 02904 Phone: 401-274-2500 | |
Mr. Brian P Shea, MA Counselor Medicare: Not Enrolled in Medicare Practice Location: 50 Park Row W, #426, Providence, RI 02903 Phone: 617-455-2788 | |
Alisha Choquette, AA, ACDP Counselor Medicare: Not Enrolled in Medicare Practice Location: 66 Burnett St, Providence, RI 02907 Phone: 401-785-0050 Fax: 401-941-0089 | |
Betsy Riccio, Counselor Medicare: Not Enrolled in Medicare Practice Location: 300 River Ave, Providence, RI 02908 Phone: 401-465-1955 | |
Miss Ashley L Addison, BA, LCDP, CCSP Counselor Medicare: Not Enrolled in Medicare Practice Location: 530 N Main St, Providence, RI 02904 Phone: 401-276-4100 | |
Jennifer Ortiz, Counselor Medicare: Not Enrolled in Medicare Practice Location: 66 Pavilion Ave, Providence, RI 02905 Phone: 401-461-9110 | |
Shane Lima, Counselor Medicare: Not Enrolled in Medicare Practice Location: 66 Pavilion Ave, Providence, RI 02905 Phone: 401-461-9110 |