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

Individual provider Community Health Worker · NPI 1396402566

Tyshanae Jackson, QMHSCMS is a Community Health Worker in Toledo, Ohio. Practices as a sole proprietor. Licensed in Ohio.

Licensed in
OH
In the registry since
2021
Specialties on file
2
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Practice location Address checks out

1832 Adams St
Toledo, OH 43604-4428
Phone: (440) 260-8300
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Community Health Worker (primary) Taxonomy 172V00000X (OH)
Case Manager/Care Coordinator Taxonomy 171M00000X (OH)

Record details

NPI number1396402566
Entity typeIndividual (Type 1)
GenderFemale
Credentials QMHSCMS
Sole proprietorYes
NPI enumeratedNovember 23, 2021
Last updated in NPPESNovember 23, 2021
Certification dateNovember 23, 2021

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