MEDICARE: RENEE M JACKSON

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	101YM0800X	Mental Health Counselor	C.1801060	OH

General Provider Information

NPI Number	:	1962979658
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RENEE M JACKSON

Provider Business Mailing Address
First Line	:	7565 GRANGER RD
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44125-4818
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	860 E 222ND ST
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44123-3317
Country	:	US
Telephone Number	:	216-447-9600
Fax Number	:

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

Provider Enumeration Date	:	10/31/2018
Last Update Date	:	10/31/2018

Similar Medicare Providers

1528838885 — KIMBERLY POWELL
Practice Location Address:

3825 E 53RD ST
CLEVELAND, OH
44105-3317

Practice Phone: 216-202-5081
Practice Fax: 216-591-0118

1861739633 — YOLANDA RANDALL LPN
Practice Location Address:

20390 S LAKE SHORE BLVD
CLEVELAND, OH
44123-2135

Practice Phone: 216-855-2650
Practice Fax:

1508310640 — NICOLE DENISE HACKNEY LPN
Practice Location Address:

20500 PRIDAY AVE
CLEVELAND, OH
44123-2613

Practice Phone: 216-727-6816
Practice Fax:

1467049189 — STEPHEN JOHNSON
Practice Location Address:

714 E 222ND ST # 2
CLEVELAND, OH
44123-2034

Practice Phone: 216-359-8205
Practice Fax:

1245960699 — DEBORAH MCGHEE
Practice Location Address:

20870 CRYSTAL AVE
CLEVELAND, OH
44123-2116

Practice Phone: 216-370-0856
Practice Fax:

1962134031 — RAY MCCLOUD
Practice Location Address:

22070 LAKE SHORE BLVD APT 4
CLEVELAND, OH
44123-1745

Practice Phone: 216-304-9864
Practice Fax:

Directions to “ RENEE M JACKSON ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.