Provider Demographics
NPI:1699454900
Name:JAMERSON, ARIANNA KAREENA (MED)
Entity type:Individual
Prefix:
First Name:ARIANNA
Middle Name:KAREENA
Last Name:JAMERSON
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4450 S DREXEL BLVD
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60653-3505
Mailing Address - Country:US
Mailing Address - Phone:773-954-3220
Mailing Address - Fax:
Practice Address - Street 1:1901 N CLYBOURN AVE STE 304
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614-6808
Practice Address - Country:US
Practice Address - Phone:312-659-4718
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-13
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health