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TONY A JACKSON CDCA
NPI 1568968626
Counselor - Addiction (Substance Use Disorder) in Shelby, OH

Active since April 05, 2018
2775 STATE ROUTE 39, SHELBY, OH 44875(419) 747-3322 Get Directions Write a Review

NPPES record last updated: April 5, 2018. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Tony A Jackson Cdca NPPES

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

TONY A JACKSON CDCA (NPI 1568968626) is an individual addiction (substance use disorder) provider in Shelby, Ohio, licensed in Ohio (CDCA165157) and active in the NPI registry since April 2018.

NPPES Registry Identity

NPI1568968626
Entity TypeIndividualMale
Primary Taxonomy101YA0400X
Provider Legal NameTONY A JACKSONCredential: CDCA
Location Address2775 STATE ROUTE 39Shelby, OH 44875-9466
Mailing Address2775 State Route 39Shelby, OH 44875-9466 · (419) 747-3322
Phone(419) 747-3322
Sole ProprietorYes
Enumeration DateApril 5, 2018
✔ NPI 1568968626 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
License✔ Licensed in OH · CDCA165157
2775 STATE ROUTE 39, Shelby, OH 44875
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Other Identifiers 1

Medicaid2876928OH

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.

ERICH DUMBECK PCC-S
Counselor (Professional)
2775 STATE ROUTE 39
SHELBY, OH 44875
Richland County (419) 577-5394
MISS MYCHAL DEEB LSW
Social Worker
2775 STATE ROUTE 39
SHELBY, OH 44875
Richland County (419) 747-3322
NICOLE BROWN LPCC
Counselor (Mental Health)
2775 STATE ROUTE 39
SHELBY, OH 44875
Richland County (419) 747-3322
MS. STEPHNIE DARBY RN
Registered Nurse
2775 STATE ROUTE 39
SHELBY, OH 44875
Richland County (419) 747-0833
MR. MICHAEL EARL BUSSERT BA, CDCA
Counselor (Addiction (Substance Use Disorder))
2775 STATE ROUTE 39
SHELBY, OH 44875
Richland County (419) 747-3322
MR. ERIK THOMAS MCKEAN
Counselor (Addiction (Substance Use Disorder))
2775 STATE ROUTE 39
SHELBY, OH 44875
Richland County (419) 747-3322
MRS. BERNADETTE I. GUCKERT CDCA
Counselor (Mental Health)
2775 STATE ROUTE 39
SHELBY, OH 44875
Richland County (419) 747-3322
MS. AMY BETH CLOSE LSW, LCDC III
Counselor (Addiction (Substance Use Disorder))
2775 STATE ROUTE 39
SHELBY, OH 44875
Richland County (419) 747-0826

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 Tony Jackson's NPI number?

The NPI number for Tony Jackson is 1568968626. It was assigned to this individual provider in the NPPES registry on April 5, 2018.

Where is Tony Jackson located?

Tony Jackson practices at 2775 State Route 39, Shelby, OH 44875. The listed phone number is (419) 747-3322.

What is Tony Jackson's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

When was this NPI record last updated?

The NPPES record for Tony Jackson was last updated on April 5, 2018. NPI Profile syncs with the weekly NPPES data releases published by CMS.