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

Johnny Jackson III

Individual provider Peer Specialist · NPI 1336929884

Johnny Jackson III is a Peer Specialist in Fairfield, Ohio. Practices as a sole proprietor. Licensed in Ohio.

Licensed in
OH
In the registry since
2023
Specialties on file
2

Practice location Address checks out

6570 Sosna Dr
Fairfield, OH 45014-2222
Phone: (513) 942-4673
Fax: (513) 860-1439
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.004453 (OH)
Case Manager/Care Coordinator Taxonomy 171M00000X

Record details

NPI number1336929884
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedOctober 3, 2023
Last updated in NPPESNovember 16, 2023
Certification dateNovember 16, 2023
Mailing address100 Crowne Point Pl, Cincinnati, OH 45241-5427

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