| Mark A Jackson, LCSW | |
|
513 Menendez St, Venice, FL 34285-2233 | |
| (917) 319-1210 | |
| Not Available |
| Full Name | Mark A Jackson |
|---|---|
| Gender | Male |
| Speciality | Social Worker - Clinical |
| Location | 513 Menendez St, Venice, Florida |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972990844 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | SW11508 (Florida) | Primary |
| Entity Name | Grow Healthcare Group Pa |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1245845932 PECOS PAC ID: 3476961368 Enrollment ID: O20210414000053 |
| Entity Name | Mindful Mental Health Services - Fl Gulf Sw Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1568121267 PECOS PAC ID: 9234523325 Enrollment ID: O20220307001924 |
| Mailing Address | Practice Location Address |
|---|---|
| Mark A Jackson, LCSW 5528 Cartagena Dr, Sarasota, FL 34233-3504 Ph: (917) 319-1210 | Mark A Jackson, LCSW 513 Menendez St, Venice, FL 34285-2233 Ph: (917) 319-1210 |
Mrs. Diane K Clukey Chenard, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 230 Tamiami Trl S Ste 3, Venice, FL 34285 Phone: 941-473-3838 | |
Mrs. Christine Marie Digangi-korbel, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 12161 Mercado Dr Ste 258, Venice, FL 34293 Phone: 847-920-7070 | |
Nancy J Stetter-coblentz, LCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 1790 E Venice Ave Ste 204, Venice, FL 34292 Phone: 941-488-8884 Fax: 941-488-5554 | |
Mrs. Elizabeth M Adams, SOCIAL WORKER, CLINI Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 492 Buttonbush Lane, Venice, FL 34293 Phone: 941-441-5137 Fax: 305-453-5144 | |
Richard Banton, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 20398 Lagente Cir, Venice, FL 34293 Phone: 304-322-5509 | |
Mrs. Nicole Kay Cummings, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 4195 Tamiami Trl S Pmb #126, Venice, FL 34293 Phone: 941-497-2244 Fax: 941-497-2244 | |
Barbara J. Kirk, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 333 Tamiami Trl S Ste 288, Venice, FL 34285 Phone: 941-525-2427 |