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

Mavis Jackson

Individual provider Child & Adolescent Psychiatric/Mental Health Registered Nurse · NPI 1083455315

Mavis Jackson is a Child & Adolescent Psychiatric/Mental Health Registered Nurse in Orangeburg, New York. Licensed in New York. Registered with an NPI since 2024.

Licensed in
NY
In the registry since
2024

Practice location Address checks out

140 Old Orangeburg Rd
Orangeburg, NY 10962-1157
Phone: (845) 680-7800
Show map & directions

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

Specialties & licences

Child & Adolescent Psychiatric/Mental Health Registered Nurse (primary) Taxonomy 163WP0807X · Licence 572849 (NY)

Record details

NPI number1083455315
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJune 3, 2024
Last updated in NPPESJune 3, 2024
Certification dateJune 2, 2024
Mailing address37 Woodfield Rd, Pomona, NY 10970-2216

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