Gianna Latrice Jackson, GMFT

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

2255 Crain Hwy Ste 107
Waldorf, MD 20601-3186

Phone

(301) 292-2778

NPI assigned

Dec 17, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1545004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545004800000",
    "number": "1194297036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 644",
            "city": "TEMPLE HILLS",
            "state": "MD",
            "postal_code": "207570644",
            "telephone_number": "619-944-9971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2255 CRAIN HWY STE 107",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206013186",
            "telephone_number": "301-292-2778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "GIANNA",
        "middle_name": "LATRICE",
        "name_prefix": "Ms.",
        "credential": "GMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-12-17",
        "last_updated": "2018-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "223042",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ruth Clarie Jackson-Hayes, M.A., L.P.C.
• Angela Jackson
• Brendalan Jackson, LCSW
• Crystal I Jackson, LGSW-G
• Dainty J Jackson, D. O.
• Joyce Jacquetta Jackson, NP
• Nathaniel Jackson Jr.
• Janelle Adrienne Jacobs
• Geraldine Jessica Jaganathan, PTA
• Amin Jahedi

• Counselor in Waldorf, MD
• Providers in Waldorf, MD by specialty
• Counselor in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2018; 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.