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CHARLEY MARIE MOORE JACKSON
NPI 1659906287
Counselor - Addiction (Substance Use Disorder) in Blue Ash, OH

Active since March 04, 2020
9403 KENWOOD RD, BLUE ASH, OH 45242(513) 543-6600(513) 745-0037 Get Directions Write a Review

NPPES record last updated: March 4, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Charley Marie Moore Jackson NPPES

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

CHARLEY MARIE MOORE JACKSON (NPI 1659906287) is an individual addiction (substance use disorder) provider in Blue Ash, Ohio and active in the NPI registry since March 2020.

NPPES Registry Identity

NPI1659906287
Entity TypeIndividualFemale
Primary Taxonomy101YA0400X
Provider Legal NameCHARLEY MARIE MOORE JACKSON
Location Address9403 KENWOOD RDBlue Ash, OH 45242-6895
Mailing Address9403 Kenwood RdBlue Ash, OH 45242-6895 · (513) 543-6600 · Fax (513) 745-0037
Phone(513) 543-6600
Fax(513) 745-0037
Sole ProprietorYes
Enumeration DateMarch 4, 2020
NPPES CertifiedMarch 4, 2020
✔ NPI 1659906287 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
9403 KENWOOD RD, Blue Ash, OH 45242
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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.

DR. MARY K MOSKO MD
Family Medicine
9403 KENWOOD RD, SUITE C208
BLUE ASH, OH 45242
Hamilton County (513) 891-5532
SOUTHERN OHIO RECOVERY GROUP, INC
Family Medicine (Addiction Medicine)
9403 KENWOOD RD
BLUE ASH, OH 45242
Hamilton County (513) 543-6600
GARY THOMAS RATLIFF LISW, LICDC III
Social Worker (Clinical)
9403 KENWOOD RD
BLUE ASH, OH 45242
Hamilton County (513) 280-1523
KENDRA R NICKELL
Counselor (Addiction (Substance Use Disorder))
9403 KENWOOD RD
BLUE ASH, OH 45242
Hamilton County (513) 543-6600
DR. LINDA DEAN RHYNE PH.D.
Psychologist (Clinical)
9403 KENWOOD RD, SUITE B110
CINCINNATI, OH 45242
Hamilton County (513) 794-9661
DR. SUZANNE F MATUNIS MD
Family Medicine
9403 KENWOOD RD, SUITE C208
CINCINNATI, OH 45242
Hamilton County (513) 891-5532
SUSAN ANNE CONRAD OT
Occupational Therapist
9403 KENWOOD RD, SUITE A120
CINCINNATI, OH 45242
Hamilton County (513) 791-5766
SHANA GADOMSKI
Case Manager/Care Coordinator
9403 KENWOOD RD
BLUE ASH, OH 45242
Hamilton County (513) 543-6600

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 Charley Moore Jackson's NPI number?

The NPI number for Charley Moore Jackson is 1659906287. It was assigned to this individual provider in the NPPES registry on March 4, 2020.

Where is Charley Moore Jackson located?

Charley Moore Jackson practices at 9403 Kenwood Rd, Blue Ash, OH 45242. The listed phone number is (513) 543-6600.

What is Charley Moore 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 Charley Moore Jackson was last updated on March 4, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.