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SPENCER JACKSON
NPI 1164185484
Peer Specialist in Pryor, OK

Active since October 14, 2021
109 N FAIRLAND ST, PRYOR, OK 74361(918) 825-1405 Get Directions Write a Review

NPPES record last updated: October 14, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Spencer Jackson NPPES

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

SPENCER JACKSON (NPI 1164185484) is an individual peer specialist in Pryor, Oklahoma and active in the NPI registry since October 2021.

NPPES Registry Identity

NPI1164185484
Entity TypeIndividualMale
Primary Taxonomy175T00000X
Provider Legal NameSPENCER JACKSON
Location Address109 N FAIRLAND STPryor, OK 74361-4205
Mailing Address109 N Fairland StPryor, OK 74361-4205 · (918) 825-1405
Phone(918) 825-1405
Sole ProprietorNo
Enumeration DateOctober 14, 2021
NPPES CertifiedOctober 14, 2021
✔ NPI 1164185484 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPeer SpecialistOther Service Providers
Taxonomy Code175T00000X
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
109 N FAIRLAND ST, Pryor, OK 74361
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Other Providers at the Same Location NPPES 20

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

KALI ROSE KERNS
Peer Specialist
109 N FAIRLAND ST
PRYOR, OK 74361
Mayes County (918) 825-1405
JACKIE ELAINE HORTON
Case Manager/Care Coordinator
109 N FAIRLAND ST
PRYOR, OK 74361
Mayes County (918) 825-1405
WHITNEY JOANNA PHILLIPS
Peer Specialist
109 N FAIRLAND ST
PRYOR, OK 74361
Mayes County (918) 825-1405
BREANNA NICOLE COOK MHR, LPC-C
Counselor (Mental Health)
109 N FAIRLAND ST
PRYOR, OK 74361
Mayes County (918) 825-1401
NICOLE BURNHAM LPN
Licensed Practical Nurse
109 N FAIRLAND ST
PRYOR, OK 74361
Mayes County (918) 825-1405
STEPHANIE RENEE STACY
Peer Specialist
109 N FAIRLAND ST
PRYOR, OK 74361
Mayes County (918) 273-1841
CRYSTAL MICHELLE CUMMINS
Case Manager/Care Coordinator
109 N FAIRLAND ST
PRYOR, OK 74361
Mayes County (918) 825-1405
KANDICE BRIANS
Peer Specialist
109 N FAIRLAND ST
PRYOR, OK 74361
Mayes County (918) 273-1841

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 Spencer Jackson's NPI number?

The NPI number for Spencer Jackson is 1164185484. It was assigned to this individual provider in the NPPES registry on October 14, 2021.

Where is Spencer Jackson located?

Spencer Jackson practices at 109 N Fairland St, Pryor, OK 74361. The listed phone number is (918) 825-1405.

What is Spencer Jackson's specialty?

The primary specialty registered for this NPI is Peer Specialist with taxonomy code 175T00000X.

When was this NPI record last updated?

The NPPES record for Spencer Jackson was last updated on October 14, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.