NPIMap

Organization Active NPI

Angelique Jackson

  • Adult Mental Health Clinic/Center
  • Catasauqua, PA
National Provider Identifier
1780092288
Registry record updated Jul 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
ANGELIQUE JACKSON
Practice address
539 Lehigh St
Catasauqua, PA 18032-2017
Phone
(484) 891-0906
NPI assigned
Jul 28, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2014

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

Authorized official

Name
Angelique Jackson
Title
Therapist
Phone
(484) 891-0906

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Adult Mental Health Clinic/Center 261QM0850X Primary

Addresses

Primary practice location

539 Lehigh St
Catasauqua, PA 18032-2017

Mailing address

539 Lehigh St
Catasauqua, PA 18032-2017
Phone (484) 891-0906

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1406505600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1406505600000",
    "number": "1780092288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "539 LEHIGH ST",
            "city": "CATASAUQUA",
            "state": "PA",
            "postal_code": "180322017",
            "telephone_number": "484-891-0906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "539 LEHIGH ST",
            "city": "CATASAUQUA",
            "state": "PA",
            "postal_code": "180322017",
            "telephone_number": "484-891-0906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANGELIQUE JACKSON",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-28",
        "last_updated": "2014-07-28",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "ANGELIQUE",
        "authorized_official_title_or_position": "THERAPIST",
        "authorized_official_telephone_number": "484-891-0906"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Catasauqua, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2014; 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.