Tiffany Jackson

Individual provider Active NPI Case Manager/Care Coordinator · Brookfield, OH

NPI 1053968412 · NPPES record last updated Dec 12, 2024

Key facts

NPI
1053968412
Entity type
Individual (NPI type 1)
Primary specialty
Case Manager/Care Coordinator 171M00000X
Practice address
7529 Warren Sharon Rd
Brookfield, OH 44403-9796
Phone
(740) 415-1138
NPI assigned
Aug 21, 2019
Sex
Female
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora-Recovery, LLC Current
since Dec 15, 2024
Accepting new patients
Aurora-Recovery, LLC Current
since Dec 15, 2024
Accepting new patients

Locations

7529 Warren Sharon Rd
Brookfield, OH 44403
Phone (330) 421-8247

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X
Behavior Technician 106S00000X
Case Manager/Care Coordinator 171M00000X Yes

Addresses

Primary practice location

7529 Warren Sharon Rd
Brookfield, OH 44403-9796

Mailing address

445 E Dublin Granville Rd
Worthington, OH 43085-3192
Phone (614) 844-3800

Other practice location 1

786 Ferndale Rd
Mansfield, OH 44907-1757
Phone (614) 844-3800

Other providers in Brookfield, OH

All providers in Brookfield, OH · Case Manager/Care Coordinator in Ohio

Sources for this page

Verify at the official NPI Registry.