Daphime Jackson, CSC-AD

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

8737 Brooks Dr Ste 108
Easton, MD 21601-7474

Phone

(800) 867-2395

Fax

(410) 443-0842

NPI assigned

Jun 25, 2019

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

• Daphine Camper-Jackson Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Lifes Energy Wellness Center Inc.

  • Community/Behavioral Health Agency
  • Salisbury, MD
  • NPI 1528726460
  NPD (past)
• Lifes Energy Wellness Center Inc.

  • Community/Behavioral Health Agency
  • Salisbury, MD
  • NPI 1912579822
  NPD (past)

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

{
    "created_epoch": "1561420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566950400000",
    "number": "1235790783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 123",
            "city": "EASTON",
            "state": "MD",
            "postal_code": "216018901",
            "telephone_number": "800-867-2395",
            "fax_number": "410-443-0842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8737 BROOKS DR STE 108",
            "city": "EASTON",
            "state": "MD",
            "postal_code": "216017474",
            "telephone_number": "800-867-2395",
            "fax_number": "410-443-0842"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2324 West Zion Road Suite 112",
            "address_2": "Suite 112",
            "address_purpose": "LOCATION",
            "city": "Salisbury",
            "state": "MD",
            "postal_code": "21801",
            "country_code": "US",
            "telephone_number": "800-867-2395",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "514 Poplar St",
            "address_purpose": "LOCATION",
            "city": "Cambridge",
            "state": "MD",
            "postal_code": "216131834",
            "country_code": "US",
            "telephone_number": "800-867-2395",
            "fax_number": "410-443-0842",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "DAPHIME",
        "credential": "CSC-AD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-25",
        "last_updated": "2019-08-28",
        "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": "DAPHINE",
            "last_name": "CAMPER-JACKSON",
            "credential": "CSC-AD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Addiction (Substance Use Disorder) Counselor in Easton, MD
• Providers in Easton, MD by specialty
• Addiction (Substance Use Disorder) Counselor in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2019; 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.