Stephenie C Jackson, PMHNP
Nurse Practitioner, Psych/Mental Health in Mattapan, Massachusetts
1427722917- Practice location
- 119 W Selden St, Mattapan, MA 02126-2348
- Phone
- 617-407-7879
- Fax
- —
- Last updated
- March 25, 2025
Stephenie C Jackson is a Nurse Practitioner, Psych/Mental Health based in Mattapan, MA. Stephenie C Jackson practices in Mattapan, MA and has the professional credentials of PMHNP. The NPI Number for Stephenie C Jackson is 1427722917 and holds a License No. 2118 (MA). The current practice location address for Stephenie C Jackson is 119 W Selden St, Mattapan, MA 02126-2348 and can be reached out via phone at 617-407-7879.
Provider Profile Details
- NPI Number
- 1427722917
- Provider Name
- Stephenie C Jackson
- Credential
- PMHNP
- Provider Entity Type
- Individual
- Gender
- Female
- Address
- 119 W Selden St, Mattapan, MA 02126-2348
- Phone Number
- 617-407-7879
- Primary Taxonomy
- Nurse Practitioner, Psych/Mental Health · 363LP0808X
- Sole Proprietor
- Yes
- Other Names
- Stephenie Jackson-Wilson, PMHNP (Other Name)
- Provider Enumeration Date
- August 6, 2021
- Last Update Date
- March 25, 2025
- Certification Date
- March 25, 2025
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 119 W Selden St
Mattapan, MA 02126-2348 - City
- Mattapan
- State
- Massachusetts
- Zip
- 02126-2348
- Phone Number
- 617-407-7879
Provider Business Mailing Address Details
- Address
- 119 W Selden St # 2
Mattapan, MA 02126-2348 - City
- Mattapan
- State
- MA
- Zip
- 02126-2348
- Phone Number
- 617-407-7879
License Information
- License Number (1)
- 2118
- License State (1)
- MA
- Taxonomy (1)
- Counselor, Addiction (Substance Use Disorder) · 101YA0400X
- License Number (2)
- 6873
- License State (2)
- MA
- Taxonomy (2)
- Registered Nurse, Addiction (Substance Use Disorder) · 163WA0400X
- License Number (3)
- RN2288835
- License State (3)
- MA
- Taxonomy (3)
- Nurse Practitioner, Psych/Mental Health · 363LP0808X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Stephenie C Jackson, PMHNP?
The NPI number of Stephenie C Jackson, PMHNP is 1427722917. It was assigned on August 6, 2021 and is currently active in the NPPES registry.
What is the specialty of Stephenie C Jackson, PMHNP?
Stephenie C Jackson, PMHNP is registered under the primary taxonomy Nurse Practitioner, Psych/Mental Health (code 363LP0808X), licensed in MA under license number 2118.
Where does Stephenie C Jackson, PMHNP practice?
The practice location is 119 W Selden St, Mattapan, MA 02126-2348. The office can be reached at 617-407-7879 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1427722917 directly on the NPPES registry website.