Nadine Yvette Jackson, CASAC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

2-11436 Issued in NY

Practice address

1751 Park Ave
New York, NY 10035-2809

Phone

(212) 991-4994

Fax

(212) 414-1431

NPI assigned

Jul 24, 2017

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

State licenses

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.

• Housing Works Health Services III, Inc.

  • Federally Qualified Health Center (FQHC)
  • Brooklyn, NY
  • NPI 1114950151
  NPD (past)

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

{
    "created_epoch": "1500854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1500854400000",
    "number": "1740703560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 W 128TH ST APT 7",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100273027",
            "telephone_number": "646-657-0063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1751 PARK AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100352809",
            "telephone_number": "212-991-4994",
            "fax_number": "212-414-1431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "NADINE",
        "middle_name": "YVETTE",
        "credential": "CASAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-24",
        "last_updated": "2017-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "2-11436",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marilyn M. Jackson, M.D
• Marion Louise Jackson, LMSW
• Marlene Jackson, RN
• Melissa Anne Jackson, M.S.ED
• Michael Jackson, M.D.
• Nadira Kai Jackson, MA, MHC-LP
• Naieema Jackson, RN
• Naishia Jackson
• Naomi Jackson
• Natia Jackson

• Addiction (Substance Use Disorder) Counselor in New York, NY
• Providers in New York, NY by specialty
• Addiction (Substance Use Disorder) Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2017; 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.