Active NPI
Cassandra Faith Jackson
- Peer Specialist
- Albuquerque, NM
National Provider Identifier
1861114456
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Peer Specialist
- License
- 1460
- Practice address
- 239 Elm St NE
Albuquerque, NM 87102-3672 - Phone
- (505) 339-7360
- NPI assigned
- Sep 12, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | |||
| Case Manager/Care Coordinator | 171M00000X | |||
| Peer Specialist | 175T00000X | 1460 | NM | Primary |
Addresses
Primary practice location
239 Elm St NE
Albuquerque, NM 87102-3672
Mailing address
239 Elm St NE
Albuquerque, NM 87102-3672
Phone (505) 339-7360
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1460 | NM | MD | Peer Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1662940800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1861114456",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "239 ELM ST NE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871023672",
"telephone_number": "505-339-7360"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "239 ELM ST NE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871023672",
"telephone_number": "505-339-7360"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "CASSANDRA",
"middle_name": "FAITH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-09-12",
"last_updated": "2026-07-13",
"certification_date": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": null,
"license": null,
"primary": false
},
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": false
},
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": "NM",
"license": "1460",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Albuquerque, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.