Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dominique Shavanta Jackson

Individual provider Case Manager/Care Coordinator · NPI 1689426793

Dominique Shavanta Jackson is a Case Manager/Care Coordinator in Cleveland, Ohio. Practices as a sole proprietor. Licensed in Ohio.

Licensed in
OH
In the registry since
2024
Specialties on file
4

Practice location Address checks out

4114 E 141st St
Cleveland, OH 44128-1806
Phone: (216) 501-3289
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Peer Specialist (primary) Taxonomy 175T00000X · Licence APS.005574 (OH)
Case Manager/Care Coordinator Taxonomy 171M00000X
Adult Companion Taxonomy 372600000X
Nurse's Aide Taxonomy 376K00000X

Record details

NPI number1689426793
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedApril 2, 2024
Last updated in NPPESDecember 2, 2024
Certification dateDecember 2, 2024

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