LEE JACKSON - NPI 1336092048 - Peer Specialist in Berea, OH

Q: What is Lee Jackson's NPI number?

The NPI number for Lee Jackson is 1336092048. It was assigned to this individual provider in the NPPES registry on February 20, 2026.

Q: What is Lee Jackson's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Lee Jackson was last updated on February 20, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.

On this page

About Lee Jackson NPPES

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

LEE JACKSON (NPI 1336092048) is an individual peer specialist in Berea, Ohio and active in the NPI registry since February 2026.

NPPES Registry Identity

NPI1336092048

Entity TypeIndividualMale

Primary Taxonomy175T00000X

Provider Legal NameLEE JACKSON

Location Address343 W BAGLEY RDBerea, OH 44017-1370

Mailing Address343 W Bagley RdBerea, OH 44017-1370 · (440) 260-6835

Phone(440) 260-6835

Sole ProprietorYes

Enumeration DateFebruary 20, 2026

NPPES CertifiedFebruary 20, 2026

✔ NPI 1336092048 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.

343 W BAGLEY RD, Berea, OH 44017

Open in Google Maps ↗

Other Providers at the Same Location NPPES 11

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

ERIKA HANNAH

Marriage & Family Therapist