National Provider Identifier

Shanika Jackson

Shanika Jackson is listed in the NPPES registry with a primary specialty of Mental Health Counselor in Williamsville, NY and a listed phone number of (716) 424-7335.

NPI 1356125157Williamsville, NYMental Health Counselor

Profile Overview

NPI
1356125157
Provider Type
Individual
Primary Specialty
Mental Health Counselor
Enumeration Date
August 22, 2023
Last Updated
March 21, 2024

Practice Location

  • 330 Hunters Ln
  • Williamsville, NY 14221-3319

Phone: (716) 424-7335

Mailing Address

  • 484 Fruitwood Ter
  • Williamsville, NY 14221-1910

Specialties

  • Mental Health Counselor (101YM0800X)
  • Addiction (Substance Use Disorder) Counselor (101YA0400X)
  • Home Health Agency (251E00000X)
Full Record
NPI
1356125157
Entity Type
Individual
Last Name
Jackson
First Name
Shanika
Mailing Street Address
484 Fruitwood Ter
Mailing City
Williamsville
Mailing State
NY
Mailing ZIP Code
14221-1910
Mailing Country
US
Mailing Phone
(716) 424-7335
Practice Street Address
330 Hunters Ln
Practice City
Williamsville
Practice State
NY
Practice ZIP Code
14221-3319
Practice Country
US
Practice Phone
(716) 424-7335
Enumeration Date
August 22, 2023
Last Updated
March 21, 2024
Sex
Female
Sole Proprietor
Yes
Taxonomy Group 1
193200000X Multi-Specialty Group
Certification Date
March 21, 2024
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Mental Health Counselor (101YM0800X), Addiction (Substance Use Disorder) Counselor (101YA0400X), Home Health Agency (251E00000X)