Deborah Ann Jackson, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

001443 Issued in CT

Practice address

47 Town St
Norwich, CT 06360-2315

Phone

(860) 892-7042

Fax

(860) 823-3060

NPI assigned

Apr 19, 2011

Last updated

Apr 19, 2011By 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

Other identifiers 1

Other names 1

• Deborah Ann D'Andrea Former name

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": "1303171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303171200000",
    "number": "1942590310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 TOWN ST",
            "city": "NORWICH",
            "state": "CT",
            "postal_code": "063602315",
            "telephone_number": "860-892-7042",
            "fax_number": "860-823-3060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47 TOWN ST",
            "city": "NORWICH",
            "state": "CT",
            "postal_code": "063602315",
            "telephone_number": "860-892-7042",
            "fax_number": "860-823-3060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "DEBORAH",
        "middle_name": "ANN",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-19",
        "last_updated": "2011-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CT",
            "license": "001443",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004235942",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEBORAH",
            "last_name": "D'ANDREA",
            "middle_name": "ANN",
            "credential": "LMFT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Daquan Ishman
• Julia Israelski, LCSW
• Kara Izzo, PA-C
• Jacc Healthcare Center of Norwich, LLC (Three Rivers)
• Athena Jackson
• Elizabeth Detweiler Jackson, APRN
• Martina S Jackson, LMSW
• Sarah Jayne Jacob, LCSW
• Rachel Jadczak, CPNP-PC
• Kandhasamy Jagathambal, MD

• Marriage & Family Therapist in Norwich, CT
• Providers in Norwich, CT by specialty
• Marriage & Family Therapist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2011; 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.