National Provider Identifier Database

SOMER JACKSON
Other Service Providers

Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.


Contact Information

SOMER JACKSON
3001 WARRIOR LN
POPLAR BLUFF, MO63901-8685
Phone: 573-686-1200
Fax:
Website:
Specialty Taxonomy Code
* Other Service Providers 175T00000X
Behavior Technician 106S00000X

* Indicates primary specialty

NPI Profile & details for SOMER JACKSON

NPI Number 1760191803
Credentials
Entity Individual
Enumeration date 11/17/2022
Last updated 09/20/2024 - More than a year ago
Sole proprietor1 No
Identifiers
  • MO License #: 15674
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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