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

Eboni Shantelle Jackson

Individual provider Peer Specialist · NPI 1265229595

Eboni Shantelle Jackson is a Peer Specialist in Cody, Wyoming. Works from 3 locations. Licensed in Wyoming.

Licensed in
WY
In the registry since
2025

Practice location Address checks out

707 Sheridan Ave
Cody, WY 82414-3409
Phone: (307) 578-2486
Fax: (307) 578-2247
Show map & directions

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

Additional practice locations (2)

  • 507 N Clark St, Powell, WY 82435-1915 — (307) 754-7970
  • 125 S Division St, Powell, WY 82435-2409 — (307) 754-7970

Specialties & licences

Peer Specialist (primary) Taxonomy 175T00000X · Licence 190 (WY)

Record details

NPI number1265229595
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedApril 21, 2025
Last updated in NPPESMarch 5, 2026
Certification dateMarch 5, 2026
Mailing address707 Sheridan Ave, Cody, WY 82414-3409

Other providers in Cody