Dr Ulysses Jackson Licensed Mental Health Counseling PLLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

DR ULYSSES JACKSON LICENSED MENTAL HEALTH COUNSELING PLLC

Practice address

89 Washington Ave
Deer Park, NY 11729-6917

Phone

(631) 767-9294

NPI assigned

Sep 2, 2022

Last updated

Sep 2, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Ulysses JacksonNPI 1376962647

Title

Owner

Phone

(631) 767-9294

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ulysses Jackson

  • Addiction (Substance Use Disorder) Counselor
  • Deer Park, NY
  • NPI 1376962647
  NPD Authorized official

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

{
    "created_epoch": "1662076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662076800000",
    "number": "1861112336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "89 WASHINGTON AVE",
            "city": "DEER PARK",
            "state": "NY",
            "postal_code": "117296917",
            "telephone_number": "631-767-9294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "89 WASHINGTON AVE",
            "city": "DEER PARK",
            "state": "NY",
            "postal_code": "117296917",
            "telephone_number": "631-767-9294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR ULYSSES JACKSON LICENSED MENTAL HEALTH COUNSELING PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-02",
        "last_updated": "2022-09-02",
        "certification_date": "2022-09-02",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "ULYSSES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "631-767-9294",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nia Alyssa Donawa
• Nicole Jeanne Dorvilier, RN
• Athina Doulaveris, O.D.
• Mary Alice Dowling, NP
• DP PT & Chiropractic, PLLC (Deer Park PTDC)
• Jeffrey Scott Drayer, DDS
• Courtney Duhning, PSY.D.
• Yolette Dumas, LPN
• Heather Dunne, RN
• Chantal Duvena

• Mental Health Counselor in Deer Park, NY
• Providers in Deer Park, NY by specialty
• Mental Health Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2022; 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.