Emily Estella Jackson, CDCA

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

174866 Issued in OH

Practice address

5555 Airport Hwy Ste 132
Toledo, OH 43615-7380

Phone

(567) 742-7200

Fax

(567) 742-7214

NPI assigned

Nov 3, 2020

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

Locations

Interoperability endpoints

• FHIR API: https://api.qualifacts.org/api/fhir/anchoraddiction/r4/

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.

• Chillicothe Acute Care Clinic, Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Toledo, OH
  • NPI 1689271827
  NPD
• Chillicothe Acute Care Clinic, Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Chillicothe, OH
  • NPI 1003116344
  NPD (past)

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

{
    "created_epoch": "1604361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604361600000",
    "number": "1831790328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5555 AIRPORT HWY STE 132",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436157380",
            "telephone_number": "567-742-7200",
            "fax_number": "567-742-7214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5555 AIRPORT HWY STE 132",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436157380",
            "telephone_number": "567-742-7200",
            "fax_number": "567-742-7214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "EMILY",
        "middle_name": "ESTELLA",
        "credential": "CDCA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-03",
        "last_updated": "2020-11-03",
        "certification_date": "2020-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "174866",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carmen Jackson
• Celeste Maggie Jackson I
• Chaislen Destine Jackson
• Ciera Jackson
• Curtis Jackson III
• Erica N Jackson
• Freddie Jackson
• Glendora D. Jackson
• Isaiah Jackson
• Jacqueline Faye Jackson

• Addiction (Substance Use Disorder) Counselor in Toledo, OH
• Providers in Toledo, OH by specialty
• Addiction (Substance Use Disorder) Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2020; 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.