Porsha Carolyn Jackson

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

1847 Mott Ave
Far Rockaway, NY 11691-4201

Phone

(718) 334-6850

Fax

(347) 246-9670

NPI assigned

Feb 1, 2016

Last updated

Feb 1, 2016By the provider in NPPES

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

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

{
    "created_epoch": "1454284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454284800000",
    "number": "1932567310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "443 BEACH 63RD ST",
            "city": "ARVERNE",
            "state": "NY",
            "postal_code": "116921420",
            "telephone_number": "347-782-9920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1847 MOTT AVE",
            "city": "FAR ROCKAWAY",
            "state": "NY",
            "postal_code": "116914201",
            "telephone_number": "718-334-6850",
            "fax_number": "347-246-9670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "PORSHA",
        "middle_name": "CAROLYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-01",
        "last_updated": "2016-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexa Brianna Nicole Jack, MD
• Jackson Heights Medical Care PC
• Annett Jackson Ricketts, LPN
• Sherryann Jackson-Anderson
• Kay-Dean Jackson
• Vanessa Jackson
• Awosely Jacob
• Sunitha Binu Jacob, M.D.
• Helen Jacobs, MS
• Joseph Jacobs

• Mental Health Counselor in Far Rockaway, NY
• Providers in Far Rockaway, 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 Feb 1, 2016; 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.