Active NPI
Cheryl Jackson, BS,CAC III
- Addiction (Substance Use Disorder) Counselor
- Aurora, CO
National Provider Identifier
1730495334
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 5440
- Practice address
- 2206 Victor St
Aurora, CO 80045-7400 - Phone
- (303) 617-2300
- Fax
- (303) 617-2397
- NPI assigned
- Aug 20, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 5440 | CO | Primary |
Addresses
Primary practice location
2206 Victor St
Aurora, CO 80045-7400
Mailing address
2206 Victor St
Aurora, CO 80045-7400
Phone (303) 617-2300
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Bachelor of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5440 | CO | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1282262400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1282262400000",
"number": "1730495334",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2206 VICTOR ST",
"city": "AURORA",
"state": "CO",
"postal_code": "800457400",
"telephone_number": "303-617-2300",
"fax_number": "303-617-2397"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2206 VICTOR ST",
"city": "AURORA",
"state": "CO",
"postal_code": "800457400",
"telephone_number": "303-617-2300",
"fax_number": "303-617-2397"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "CHERYL",
"credential": "BS,CAC III",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-08-20",
"last_updated": "2010-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "CO",
"license": "5440",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Aurora, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.