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DEMETRA SHAN JACKSON B.S.
NPI 1619228095
Counselor - Mental Health in Oklahoma City, OK

Active since September 26, 2012
1116 SW 59TH ST APT 1, OKLAHOMA CITY, OK 73109(405) 618-9411 Get Directions Write a Review

NPPES record last updated: September 26, 2012. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Demetra Shan Jackson B.s. NPPES

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

DEMETRA SHAN JACKSON B.S. (NPI 1619228095) is an individual mental health provider in Oklahoma City, Oklahoma and active in the NPI registry since September 2012.

NPPES Registry Identity

NPI1619228095
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameDEMETRA SHAN JACKSONCredential: B.S.
Location Address1116 SW 59TH ST APT 1Oklahoma City, OK 73109-4908
Mailing Address1116 Sw 59th St Apt 1Oklahoma City, OK 73109-4908 · (405) 618-9411
Phone(405) 618-9411
Sole ProprietorYes
Enumeration DateSeptember 26, 2012
✔ NPI 1619228095 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
1116 SW 59TH ST APT 1, Oklahoma City, OK 73109
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Other Providers at the Same Location NPPES

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

ISMAEL SANTIAGO
Counselor (Mental Health)
1116 SW 59TH ST APT 1
OKLAHOMA CITY, OK 73109
Oklahoma County (405) 887-9639

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 Demetra Jackson's NPI number?

The NPI number for Demetra Jackson is 1619228095. It was assigned to this individual provider in the NPPES registry on September 26, 2012.

Where is Demetra Jackson located?

Demetra Jackson practices at 1116 SW 59th St Apt 1, Oklahoma City, OK 73109. The listed phone number is (405) 618-9411.

What is Demetra 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 Demetra Jackson was last updated on September 26, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.