Rebecca Sabrina Jackson, CRPA

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

100 Kramer St Apt 3E
Staten Island, NY 10305-2549

Phone

(347) 277-1843

NPI assigned

Nov 23, 2024

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Ms. Rebecca Sabrina Jackson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1732320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732320000000",
    "number": "1023834124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 KRAMER ST APT 3E",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103052549",
            "telephone_number": "347-277-1843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 KRAMER ST APT 3E",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103052549",
            "telephone_number": "347-277-1843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "REBECCA",
        "middle_name": "SABRINA",
        "name_prefix": "Ms.",
        "credential": "CRPA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-23",
        "last_updated": "2024-11-23",
        "certification_date": "2024-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REBECCA",
            "last_name": "JACKSON",
            "middle_name": "SABRINA",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Brandon Joshua Jackson, D.D.S
• Dana Jackson, M.S.
• Jill Jackson, LPN
• Keith Ryan Jackson, M.D.
• Kelly A Jackson, OTR/L
• Sharon Jackson
• Starr Shalae Jackson
• Jaclyn Hunt
• Allen Jacob, PT,DPT
• Jeremy Jacob, PHARMD

• Addiction (Substance Use Disorder) Counselor in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Addiction (Substance Use Disorder) Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.