Mrs Sandra Jackson, LMHC | |
1955 Us Highway 1 S, Suite C-2, St Augustine, FL 32086-3708 | |
(904) 209-6222 | |
(904) 209-6291 |
Full Name | Mrs Sandra Jackson |
---|---|
Gender | Female |
Speciality | Counselor - Mental Health |
Location | 1955 Us Highway 1 S, St Augustine, Florida |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1356330765 | NPI | - | NPPES |
767122900 | Medicaid | FL | |
Z089A | Other | FL | BCBS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YM0800X | Counselor - Mental Health | MH8391 (Florida) | Primary |
101Y00000X | Counselor | MH8391 (Florida) | Secondary |
Entity Name | Sma Healthcare Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1356329163 PECOS PAC ID: 0244226363 Enrollment ID: O20040423000483 |
Mailing Address | Practice Location Address |
---|---|
Mrs Sandra Jackson, LMHC 1955 Us Highway 1 S, Suite C-2, St Augustine, FL 32086-3708 Ph: (904) 209-6222 | Mrs Sandra Jackson, LMHC 1955 Us Highway 1 S, Suite C-2, St Augustine, FL 32086-3708 Ph: (904) 209-6222 |
Daniela Treatment Panet Raymond, Counselor Medicare: Not Enrolled in Medicare Practice Location: 3574 Us 1 S, St Augustine, FL 32086 Phone: 904-217-7161 | |
Kathleen Mary Delucia, CAP Counselor Medicare: Not Enrolled in Medicare Practice Location: 3574 Us Highway 1 S Ste 101-104, St Augustine, FL 32086 Phone: 904-217-7161 Fax: 904-217-4075 | |
Jane G Koike, MA Counselor Medicare: Not Enrolled in Medicare Practice Location: 248 Southpark Cir E, St Augustine, FL 32086 Phone: 904-797-5680 Fax: 904-797-5681 | |
Melanie Leigh Weis, PHD Counselor Medicare: Not Enrolled in Medicare Practice Location: 3574 Us 1 S, St Augustine, FL 32086 Phone: 904-417-7100 | |
Dr. Nancy Frances Bent, ED.D. Counselor Medicare: Not Enrolled in Medicare Practice Location: 340 Paseo Reyes Dr, St Augustine, FL 32095 Phone: 904-318-6109 | |
Arielle Hobbs, LMHC INTERN Counselor Medicare: Not Enrolled in Medicare Practice Location: 248 Southpark Cir E, St Augustine, FL 32086 Phone: 904-797-5680 | |
Mrs. Christine Marie Livingston, PHD LMHC Counselor Medicare: Medicare Enrolled Practice Location: 196 Sawmill Forest Ct, St Augustine, FL 32086 Phone: 603-986-7589 |