Lorraine Michelle Jackson | Raleigh, NC • PECOS Search

Lorraine Michelle Jackson

Behavior Technician

Behavioral Health & Social Service Providers

421 Fayetteville St Ste 11100, Raleigh, NC 27601-1792

(555) 555-5555 (888) 880-9270

PECOS Enrollment

Based on the most recent information from CMS, provider Lorraine Michelle Jackson does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 4 days ago.

Profile Details

Provider ID
1154896728
Provider Type
Individual
Full Name
Jackson, Lorraine Michelle
Title
Mrs.

Gender
Female
Sole Proprietor
No
Enumeration Date
10/9/2018
Last Updated
10/9/2018

Contact Information

Practice Location

421 Fayetteville St Ste 11100, Raleigh, NC 27601-1792

Unlisted Fax

Mailing Location

500 Fairway Dr Ste 10, Deerfield Beach, FL 33441-1814

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 106S00000X Primary	Description Behavior Technician Behavioral Health & Social Service Providers	License Unlisted Issuer