Tanja Decarlo-Jackson

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

1400 E 12 Mile Rd
Madison Heights, MI 48071-2651

Phone

(248) 547-2223

NPI assigned

May 22, 2007

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

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": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073722161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19134 MONTROSE ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482352309",
            "telephone_number": "313-653-4652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 E 12 MILE RD",
            "city": "MADISON HEIGHTS",
            "state": "MI",
            "postal_code": "480712651",
            "telephone_number": "248-547-2223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DECARLO-JACKSON",
        "first_name": "TANJA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Denise Rose Davis, P.A.
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• Lisa Davis
• DB Labs LLC
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• Julie Decoste, LMSW
• Asilis Jose Defran, MD
• Jinane Degheim
• Megan Delmonte, PA-C
• Tammy Demeere, DPT

• Addiction (Substance Use Disorder) Counselor in Madison Heights, MI
• Providers in Madison Heights, MI by specialty
• Addiction (Substance Use Disorder) Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.