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Tiffany Renee Jackson , CDCA, CCHW

Counselor β€’ Hamilton, OH

Active NPI 1619629730 Individual Practitioner Female Practitioner
Practice location in NPPES

1490 University Blvd
Hamilton, OH 450113305

Call 5138967997 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

1490 University Blvd

Hamilton, OH 450113305

Telephone 5138967997
Organization at the Same NPPES Address or Phone
Butler Behavioral Health Services, Inc. Facility NPI 1053377184

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

NPI first issued

2022

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in Hamilton and Ohio

175 active clinicians are listed under Counselor with a practice address in Hamilton, OH (4,098 in Ohio).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Hamilton

1.1% of these 175 clinicians have the CMS telehealth indicator.

1.7% of these 175 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2023-02-02
Counselor Primary Specialty

NUCC Taxonomy Code: 101Y00000X

A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.

Counselor - Addiction (Substance Use Disorder)

NUCC Taxonomy Code: 101YA0400X

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: State Medical Board of Ohio.
Look Up on State Board Site

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

3 listed
Wendy Burnette , RN:-COA1

Nurse Practitioner - Psychiatric/Mental Health

NPI 1801219357

RN:COA1

Dr. John D'imperio , MD

Psychiatry & Neurology - Psychiatry

NPI 1275540569

Doctor of Medicine (M.D.)

Regina Wilde , NURSE PRACTITIONER

Nurse Practitioner - Psychiatric/Mental Health

NPI 1689670168

NURSEPRACTITIONER

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

9 Historical Events
πŸ“
Updated Business Mailing Address February 02, 2023

Registered at 1020 SYMMES RD, FAIRFIELD, OH 450141844 (Tel: 5138968300)

πŸ‘€
Provider Name / Credentials Updated February 02, 2023

Recorded as TIFFANY JACKSON, CDCA,CCHW

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) February 02, 2023

Counselor

βœ…
NPI Profile Active January 20, 2022

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) January 20, 2022

Registered at 1490 UNIVERSITY BLVD, HAMILTON, OH 450113305 (Tel: 5138967997)

πŸ“
Business Mailing Address (Initial Record) January 20, 2022

Registered at 1490 UNIVERSITY BLVD, HAMILTON, OH 450113305 (Tel: 5138967887)

πŸ‘€
Provider Name / Credentials (Initial Record) January 20, 2022

Recorded as TIFFANY SOWELL-JACKSON, CCHW

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) January 20, 2022

Counselor

🟒
Initial NPI Registration & Enumeration January 20, 2022

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1619629730
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: January 20, 2022
Last Update: February 02, 2023
Sole Proprietor: No

Mailing Address

1020 Symmes Rd

Fairfield, OH 450141844

Phone: 5138968300

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.