Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1265289078 Individual Practitioner Female Practitioner

Shannon M Jackson , CPRC, CCAR

Peer Specialist • Flint, MI

Professional Overview & Biography Verified Profile Summary

Shannon Jackson, CPRC, CCAR is a registered healthcare professional specializing in Peer Specialist in Flint, MI. Practice services are available at 1044 GILBERT ST under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

1044 Gilbert St

Flint, MI 485323527

Telephone 8104229406
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Peer Specialist in Flint, MI

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 10.2 Yrs
Regional Practice Density
196 Specialists

Practicing in Flint, MI (1765 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2025-09-15
Peer Specialist Primary Specialty

NUCC Taxonomy Code: 175T00000X

Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

23 Associated Practitioners
Carl Maddox , CCAR

Counselor - Addiction (Substance Use Disorder)

NPI 1154119212
Jennifer Allen , CCAR

Peer Specialist

NPI 1174351076
Tracy Hollis , MSW

Counselor - Addiction (Substance Use Disorder)

NPI 1184061152

Master of Social Work

Cortney Partridge

Licensed Practical Nurse

NPI 1194538447
Simone Jackson , MAS (AJS)

Counselor - Addiction (Substance Use Disorder)

NPI 1205214988

MAS(AJS)

Kathryn Bamba , BS CADC

Counselor - Addiction (Substance Use Disorder)

NPI 1245369867

BSCADC

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

8 Historical Events
📍
Updated Business Mailing Address September 15, 2025

Registered at 1044 GILBERT ST, FLINT, MI 485323527 (Tel: 8104229406)

👤
Provider Name / Credentials Updated September 15, 2025

Recorded as SHANNON JACKSON, CPRC, CCAR

NPI Profile Active May 01, 2024

NPI status registered as active in NPPES database

📍
Updated Practice Location May 01, 2024

Registered at 1044 GILBERT ST, FLINT, MI 485323527 (Tel: 8104229406)

📍
Updated Business Mailing Address May 01, 2024

Registered at 31581 GRATIOT AVE, ROSEVILLE, MI 480664528 (Tel: 5867834802)

👤
Provider Name / Credentials Updated May 01, 2024

Recorded as SHANNON JACKSON

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) May 01, 2024

Peer Specialist

🟢
Initial NPI Registration & Enumeration May 01, 2024

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1265289078
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: May 01, 2024
Last Update: September 15, 2025
Sole Proprietor: No

Mailing Address

1044 Gilbert St

Flint, MI 485323527

Phone: 8104229406

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.