Taylor Jackson

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

2701 17TH St
Rock Island, IL 61201-5351

Phone

(309) 779-3001

NPI assigned

Sep 23, 2022

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": "1663891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663891200000",
    "number": "1265155246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 S ELMWOOD AVE",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528022127",
            "telephone_number": "425-786-4947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 17TH ST",
            "city": "ROCK ISLAND",
            "state": "IL",
            "postal_code": "612015351",
            "telephone_number": "309-779-3001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "TAYLOR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-23",
        "last_updated": "2022-09-23",
        "certification_date": "2022-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dianna Irwin
• Shannon Geisell Isadore, COTA/L
• Ivan Kukhar MD SC
• Charlotte Consuelo Jackson
• Elizabeth Jackson, RN
• Taylor Jessica Jackson, MHP
• Westasia Jackson
• Nathan Jacobs
• Paula Jaeger, M.S.ED, LCPC
• Supriya Jalukar, M.S.

• Addiction (Substance Use Disorder) Counselor in Rock Island, IL
• Providers in Rock Island, IL by specialty
• Addiction (Substance Use Disorder) Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2022; 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.