MARCUS GEORGE JACKSON - NPI 1912658238 - Peer Specialist in Metairie, LA

Q: What is Marcus Jackson's NPI number?

The NPI number for Marcus Jackson is 1912658238. It was assigned to this individual provider in the NPPES registry on January 18, 2022.

Q: What is Marcus Jackson's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Marcus Jackson was last updated on May 31, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.

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About Marcus George Jackson NPPES

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

MARCUS GEORGE JACKSON (NPI 1912658238) is an individual peer specialist in Metairie, Louisiana, licensed in Louisiana (OBHPSS856) and active in the NPI registry since January 2022.

NPPES Registry Identity

NPI1912658238

Entity TypeIndividualMale

Primary Taxonomy175T00000X

Provider Legal NameMARCUS GEORGE JACKSON

Location Address3925 N I 10 SERVICE RD W STE 117Metairie, LA 70002-6831

Mailing Address3925 N I 10 Service Rd W Ste 117Metairie, LA 70002-6831 · (504) 455-2446

Phone(504) 455-2446

Sole ProprietorYes

Enumeration DateJanuary 18, 2022

Last NPPES UpdateMay 31, 2022

NPPES CertifiedMay 31, 2022

✔ NPI 1912658238 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPeer SpecialistOther Service Providers

Taxonomy Code175T00000X

License✔ Licensed in LA · OBHPSS856

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.

Also ListedCounselor · Mental HealthTaxonomy 101YM0800X · License NA (LA)

3925 N I 10 SERVICE RD W STE 117, Metairie, LA 70002

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