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

Individual provider Mental Health Counselor · NPI 1104587401

Elissa Nacole Jackson, RESIDENTASSISTANT is a Mental Health Counselor in Tulsa, Oklahoma. Practices as a sole proprietor. Licensed in Oklahoma.

Licensed in
OK
In the registry since
2022
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Practice location Address checks out

1719 E 27th St N
Tulsa, OK 74110-1705
Phone: (918) 982-7687
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X (OK)

Record details

NPI number1104587401
Entity typeIndividual (Type 1)
GenderFemale
Credentials RESIDENTASSISTANT
Sole proprietorYes
NPI enumeratedJanuary 7, 2022
Last updated in NPPESJanuary 7, 2022
Certification dateJanuary 7, 2022

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