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DEJA JACKSON
NPI 1114760774
Counselor - Mental Health in Sanford, FL

Active since June 13, 2024
2425 S PARK AVE, SANFORD, FL 32771(689) 247-7243 Get Directions Write a Review

NPPES record last updated: June 13, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Deja Jackson NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DEJA JACKSON (NPI 1114760774) is an individual mental health provider in Sanford, Florida, licensed in Florida (IMH25319) and active in the NPI registry since June 2024.

NPPES Registry Identity

NPI1114760774
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameDEJA JACKSON
Location Address2425 S PARK AVESanford, FL 32771-4419
Mailing Address417 Abbeywood LnCasselberry, FL 32707-5933
Phone(689) 247-7243
Sole ProprietorNo
Enumeration DateJune 13, 2024
NPPES CertifiedJune 13, 2024
✔ NPI 1114760774 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in FL · IMH25319
2425 S PARK AVE, Sanford, FL 32771
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Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ROBERT J. SMITH, M.D.
Dermatology
2425 S PARK AVE
SANFORD, FL 32771
Seminole County (407) 321-4200
CHRISTINE YOUNG
Counselor (Mental Health)
2425 S PARK AVE
SANFORD, FL 32771
Seminole County (407) 821-8582
ADRIANA TORRES
Counselor (Mental Health)
2425 S PARK AVE
SANFORD, FL 32771
Seminole County (407) 865-0495
JAMES RUJIMORA
Counselor (Mental Health)
2425 S PARK AVE
SANFORD, FL 32771
Seminole County (407) 865-0495
MS. TRISTIN MCDERMOTT
Counselor (Mental Health)
2425 S PARK AVE
SANFORD, FL 32771
Seminole County (407) 865-0495

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Deja Jackson's NPI number?

The NPI number for Deja Jackson is 1114760774. It was assigned to this individual provider in the NPPES registry on June 13, 2024.

Where is Deja Jackson located?

Deja Jackson practices at 2425 S Park Ave, Sanford, FL 32771. The listed phone number is (689) 247-7243.

What is Deja Jackson's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

When was this NPI record last updated?

The NPPES record for Deja Jackson was last updated on June 13, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.