MR. WARREN T JACKSON II QMRP, MHP - NPI 1811088057

Q: What is Warren Jackson's NPI number?

The NPI number for Warren Jackson is 1811088057. It was assigned to this individual provider in the NPPES registry on September 27, 2006.

Q: What is Warren Jackson's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Q: When was this NPI record last updated?

The NPPES record for Warren Jackson was last updated on July 8, 2007. NPI Profile syncs with the weekly NPPES data releases published by CMS.

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About Mr. Warren T Jackson Ii Qmrp, Mhp NPPES

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

MR. WARREN T JACKSON II QMRP, MHP (NPI 1811088057) is an individual mental health provider in Vienna, Illinois and active in the NPI registry since September 2006.

NPPES Registry Identity

NPI1811088057

Entity TypeIndividualMale

Primary Taxonomy101YM0800X

Provider Legal NameMR. WARREN T JACKSON IICredential: QMRP, MHP

Location Address408 E VINE STVienna, IL 62995-1612

Mailing Address408 E Vine StVienna, IL 62995-1612 · (618) 658-2611 · Fax (618) 658-2501

Phone(618) 658-2611

Fax(618) 658-2501

Sole ProprietorNo

Enumeration DateSeptember 27, 2006

Last NPPES UpdateJuly 8, 2007

✔ NPI 1811088057 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers

Taxonomy Code101YM0800X

408 E VINE ST, Vienna, IL 62995

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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.

MR. GREGORY GLENN LENCE BA MHP

Counselor (Mental Health)