Individual
KIMIKA M JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1661 ALPINE DR, COLUMBUS, OH 43229-2162
(614) 778-0815
Mailing address
1661 ALPINE DR, COLUMBUS, OH 43229-2162
(614) 778-0815
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CDCA.194441
OH
101YM0800X
Mental Health Counselor
—
—
103K00000X
Behavior Analyst
—
—
175T00000X
Peer Specialist
FPS.000303
OH
251E00000X
Home Health Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
252Y00000X
Early Intervention Provider Agency
—
—
261QA0600X
Adult Day Care Clinic/Center
—
—
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
374U00000X
Home Health Aide
—
—
385H00000X
Respite Care
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
Other
Enumeration date
06/04/2018
Last updated
12/11/2025
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