Marvina Jackson

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

218A Sunset Rd
Willingboro, NJ 08046-1110

Phone

(609) 835-6180

Fax

(609) 835-7962

NPI assigned

Apr 17, 2009

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": "1239926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1239926400000",
    "number": "1356584528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1289 ROUTE 38",
            "city": "HAINESPORT",
            "state": "NJ",
            "postal_code": "080362730",
            "telephone_number": "609-267-5656",
            "fax_number": "609-267-8892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "218A SUNSET RD",
            "city": "WILLINGBORO",
            "state": "NJ",
            "postal_code": "080461110",
            "telephone_number": "609-835-6180",
            "fax_number": "609-835-7962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "MARVINA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-04-17",
        "last_updated": "2009-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NJ",
            "license": "S4356",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charles Ndubuisi Igwebuike Sr., DO
• In Loving Hands LLC
• Including You LLC
• Innovative Life of New Jersey
• Innovative Life of New Jersey
• Fred Henry Jacobs
• Lauretta James, LPN
• Lynda M Jeanty-Edmond
• Baindu Jeneka
• Shirelle S Jenkins, MASTERS LPC

• Mental Health Counselor in Willingboro, NJ
• Providers in Willingboro, NJ by specialty
• Mental Health Counselor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2009; 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.