Individual provider Active NPI

Jasmine Kiara Jackson, MS.ED., LMHC, LPC

  • Mental Health Counselor
  • Beverly, NJ
National Provider Identifier
1003516295
Registry record updated Aug 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
018368 Issued in NY
Practice address
120 Elm St Apt W4
Beverly, NJ 08010-2530
Phone
(646) 941-3107
NPI assigned
Mar 6, 2023
Last updated
Aug 24, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 24, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X 068.0137391TELE VT
Mental Health Counselor 101YM0800X TPMC8286 FL
Mental Health Counselor 101YM0800X 37PC01307100 NJ
Mental Health Counselor 101YM0800X 018368 NY Primary

Addresses

Primary practice location

120 Elm St Apt W4
Beverly, NJ 08010-2530

Mailing address

418 Broadway # 11756
Albany, NY 12207-2922
Phone (518) 818-6769

Other practice location 1

418 Broadway # 11756
Albany, NY 12207-2922
Phone (646) 941-3107

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
TPMC8286FLMDMental Health Counselor
37PC01307100NJMDMental Health Counselor
068.0137391TELEVTMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Feelings First Mental Health Counseling PLLC Mental Health Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1678060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787529600000",
    "number": "1003516295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "418 BROADWAY # 11756",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122072922",
            "telephone_number": "518-818-6769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 ELM ST APT W4",
            "city": "BEVERLY",
            "state": "NJ",
            "postal_code": "080102530",
            "telephone_number": "646-941-3107"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "418 Broadway # 11756",
            "address_purpose": "LOCATION",
            "city": "Albany",
            "state": "NY",
            "postal_code": "122072922",
            "country_code": "US",
            "telephone_number": "646-941-3107",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "JASMINE",
        "middle_name": "KIARA",
        "credential": "MS.ED., LMHC, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-06",
        "last_updated": "2026-08-24",
        "certification_date": "2026-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "VT",
            "license": "068.0137391TELE",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "TPMC8286",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NJ",
            "license": "37PC01307100",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "018368",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beverly, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.