Martinna Tiara Jackson
Individual provider Active NPI Mental Health Counselor · Hermitage, AR
NPI 1003731340 · NPPES record last updated Aug 13, 2026
Key facts
- NPI
- 1003731340
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- Practice address
- PO Box 191
Hermitage, AR 71647-0191 - Phone
- (870) 415-3684
- NPI assigned
- Aug 13, 2026
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | AR | Yes |
Addresses
Primary practice location
PO Box 191
Hermitage, AR 71647-0191
Mailing address
PO Box 191
Hermitage, AR 71647-0191
Other providers in Hermitage, AR
All providers in Hermitage, AR · Mental Health Counselor in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 13, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.