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1700953270

NPI Code Detail

MEDICARE: DR. APRIL MICHELLE JACKSON JAMES PHD

MEDICARE: DR. APRIL MICHELLE JACKSON JAMES PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TA0400X	Addiction (Substance Use Disorder) Psychologist
2	103TA0400X	Addiction (Substance Use Disorder) Psychologist	2668	NC
3	103TC2200X	Clinical Child & Adolescent Psychologist	2668	NC
4	103TF0000X	Family Psychologist	2668	NC
5	103TC1900X	Counseling Psychologist	2668	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	015978	OTHER	NC	VALUE OPTIONS
3	2162567	OTHER	NC	CIGNA
4	010561573	OTHER	NC	TRICARE
5	016VA	OTHER	NC	GROUP BLUE CROSS BLUE SHI
6	045G4	OTHER	NC	INDIV. BLUE CROSS BLUE SH
7	AETNA	OTHER	NC	AETNA
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1700953270
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. APRIL MICHELLE JACKSON JAMES PHD

Provider Business Mailing Address
First Line	:	5510 N HESPERIDES ST
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33614-5414
Country	:	US
Telephone Number	:	813-467-6111
Fax Number	:	813-467-6111

Provider Business Practice Location Address
First Line	:	5510 N HESPERIDES ST
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33614-5414
Country	:	US
Telephone Number	:	813-467-6111
Fax Number	:	407-467-6111

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/29/2006
Last Update Date	:	07/17/2019

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Directions to “ DR. APRIL MICHELLE JACKSON JAMES PHD” Practice Location

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