Chevon Jackson, MSW

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

10018 Issued in FL

Practice address

525 NW Lake Whitney PL Ste 102
Port St Lucie, FL 34986-1605

Phone

(772) 337-8164

Fax

(772) 337-8165

NPI assigned

Jul 24, 2018

Sex

Female

Sole proprietor

Yes

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

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

{
    "created_epoch": "1532390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532390400000",
    "number": "1740767649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "516 OLIVE TREE CIR",
            "city": "GREENACRES",
            "state": "FL",
            "postal_code": "334133052",
            "telephone_number": "954-326-7776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 NW LAKE WHITNEY PL STE 102",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349861605",
            "telephone_number": "772-337-8164",
            "fax_number": "772-337-8165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "CHEVON",
        "name_prefix": "Ms.",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-24",
        "last_updated": "2018-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "10018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• J Paul Mahfood MD Inc (Rheumatology Services of Florida)
• J&M Hope Caring With Compassion Non-Medical Care Agency,LLC
• Monica Moore Jackman, OTD, MHS, OTR/L
• Salisa Jackson Garrand, LMHC
• Bridget Lashuwn Jackson, RMHCI
• Deja Jackson
• Jacob a Samander MD PA
• Nadera Jacob, RPH
• Vilna D Jacob
• Brian Bernard Jacobus, DDS, MS, PA

• Mental Health Counselor in Port St Lucie, FL
• Providers in Port St Lucie, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2018; 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.