Individual provider · Type 1 NPI
Stephenie C. Jackson, PMHNP
Psychiatric/Mental Health Nurse Practitioner · Mattapan, MA
NPI number
1427722917
Active
Practice location
119 W Selden St
Mattapan, MA 02126-2348
Mailing address
119 W Selden St # 2
Mattapan, MA 02126-2348
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 2118 (MA) |
| Addiction (Substance Use Disorder) Registered Nurse | 163WA0400X | 6873 (MA) |
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | RN2288835 (MA) |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
Another provider at this address
Other psychiatric/mental health nurse practitioner providers in Mattapan
About NPI 1427722917
Stephenie C. Jackson, PMHNP's National Provider Identifier is 1427722917, issued on Aug 6, 2021. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Mattapan, MA. The record was last updated on Mar 25, 2025.