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TYLER MASON JACKSON
NPI 1811739410
Peer Specialist in Sapulpa, OK

Active since June 12, 2024
11680 S 153RD WEST AVE, SAPULPA, OK 74066(918) 639-4684 Get Directions Write a Review

NPPES record last updated: June 12, 2024. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Tyler Mason Jackson NPPES

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

TYLER MASON JACKSON (NPI 1811739410) is an individual peer specialist in Sapulpa, Oklahoma and active in the NPI registry since June 2024.

NPPES Registry Identity

NPI1811739410
Entity TypeIndividualMale
Primary Taxonomy175T00000X
Provider Legal NameTYLER MASON JACKSON
Location Address11680 S 153RD WEST AVESapulpa, OK 74066-8564
Mailing Address1470 W Burnham AveSapulpa, OK 74066-6605 · (918) 497-6580
Phone(918) 639-4684
Sole ProprietorYes
Enumeration DateJune 12, 2024
NPPES CertifiedJune 12, 2024
✔ NPI 1811739410 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.
11680 S 153RD WEST AVE, Sapulpa, OK 74066
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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.

JIM HOSKINS
Religious Nonmedical Practitioner
11680 S 153RD WEST AVE
SAPULPA, OK 74066
Creek County (918) 639-4684
DAVID MARRS
Peer Specialist
11680 S 153RD WEST AVE
SAPULPA, OK 74066
Creek County (918) 639-6484
DENNIS SMITH
Religious Nonmedical Practitioner
11680 S 153RD WEST AVE
SAPULPA, OK 74066
Creek County (918) 639-4684
KERA TAYLOR
Religious Nonmedical Practitioner
11680 S 153RD WEST AVE
SAPULPA, OK 74066
Creek County (918) 639-4684
LIFEGATE FREEDOM RECOVERY MINISTRIES, INC.
Substance Abuse Rehabilitation Facility
11680 S 153RD WEST AVE
SAPULPA, OK 74066
Creek County (918) 639-4684
GREGORY KIRBY
Peer Specialist
11680 S 153RD WEST AVE
SAPULPA, OK 74066
Creek County (918) 639-4684
CHRISTOPHER GUIDRY
Peer Specialist
11680 S 153RD WEST AVE
SAPULPA, OK 74066
Creek County (918) 497-6580
LEON YOUNG
Religious Nonmedical Practitioner
11680 S 153RD WEST AVE
SAPULPA, OK 74066
Creek County (539) 238-6024

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 Tyler Jackson's NPI number?

The NPI number for Tyler Jackson is 1811739410. It was assigned to this individual provider in the NPPES registry on June 12, 2024.

Where is Tyler Jackson located?

Tyler Jackson practices at 11680 S 153rd West Ave, Sapulpa, OK 74066. The listed phone number is (918) 639-4684.

What is Tyler Jackson's specialty?

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

When was this NPI record last updated?

The NPPES record for Tyler Jackson was last updated on June 12, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.