Zena Auset Zechariah Diane Jackson, CADC CCAR, CRPA

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

19676 Issued in PA

Practice address

104 Davies Dr
York, PA 17402-8605

Phone

(717) 840-2300

NPI assigned

Oct 16, 2017

Last updated

Jan 25, 2024By the provider in NPPES

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

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Pyrmaid Healthcare Inc.

  • Methadone Clinic
  • York, PA
  • NPI 1740457514
  NPD (past)

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

{
    "created_epoch": "1508112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706140800000",
    "number": "1790296937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "965 LOUCKS RD # 1008",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174042201",
            "telephone_number": "631-530-7877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 DAVIES DR",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174028605",
            "telephone_number": "717-840-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "ZENA AUSET ZECHARIAH",
        "middle_name": "DIANE",
        "name_prefix": "Ms.",
        "credential": "CADC CCAR, CRPA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-10-16",
        "last_updated": "2024-01-25",
        "certification_date": "2024-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "PA",
            "license": "19676",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kevin Joseph Jackson, D.C.
• Kristen Jackson
• Rachael Ellen Jackson
• Sarah Jackson, MA, LPC
• Tiffany A Jackson, CNM
• Ron Mathew Jacob, M.D.
• Diane Kay Jacobs
• Jalissa Ann Jacobs, M.S. CCC-SLP
• Aubrey Jacobson, MD
• Melissa A Jacoby, OTR/L

• Addiction (Substance Use Disorder) Counselor in York, PA
• Providers in York, PA by specialty
• Addiction (Substance Use Disorder) Counselor in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2024; 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.