Shanika Jackson

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

330 Hunters LN
Williamsville, NY 14221-3319

Phone

(716) 424-7335

NPI assigned

Aug 22, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

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.

• Exceptional Deliverance Homecare

  • Home Health Agency
  • Williamsville, NY
  • NPI 1093568206
  NPD Authorized official

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

{
    "created_epoch": "1692662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710979200000",
    "number": "1356125157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "484 FRUITWOOD TER",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142211910",
            "telephone_number": "716-424-7335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 HUNTERS LN",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142213319",
            "telephone_number": "716-424-7335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "SHANIKA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-08-22",
        "last_updated": "2024-03-21",
        "certification_date": "2024-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": null,
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NY",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Ann Jackson, LCSW
• Cynthia Ann Jackson, LCSW-R,CASAC,CEAP
• Gerri Jackson, LPNN
• Karen Jackson, L.P.N.
• Katrina Marie Jackson
• Tammy M Jackson, LPN
• Jaclyn Butts Mental Health Counselor PLLC
• Stephanie Jacobs
• Taylor Jacobs
• Daniel R Jacobson, M.D.

• Mental Health Counselor in Williamsville, NY
• Providers in Williamsville, NY by specialty
• Mental Health Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2024; 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.