Minna R Jackson, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

0701003660 Issued in VA

Practice address

100 Ardmore St Ste 304
Blacksburg, VA 24060-5802

Phone

(276) 613-4273

NPI assigned

Mar 23, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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

• Mindy R. Jackson, LPC

  • Professional Counselor
  • Blacksburg, VA
  • NPI 1568037190
  NPD Authorized official
• Wythe Counseling Associates

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Wytheville, VA
  • NPI 1790340156
  NPD

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

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741910400000",
    "number": "1013034362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 MATEER CIR",
            "city": "BLACKSBURG",
            "state": "VA",
            "postal_code": "240605555",
            "telephone_number": "276-613-4273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 ARDMORE ST STE 304",
            "city": "BLACKSBURG",
            "state": "VA",
            "postal_code": "240605802",
            "telephone_number": "276-613-4273"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "201 Mateer Cir",
            "address_purpose": "LOCATION",
            "city": "Blacksburg",
            "state": "VA",
            "postal_code": "240605555",
            "country_code": "US",
            "telephone_number": "276-613-4273",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "MINNA",
        "middle_name": "R",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-23",
        "last_updated": "2025-03-14",
        "certification_date": "2025-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VA",
            "license": "0701003660",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701003660",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004945298",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carissa L Isbell, PHARM. D.
• Ischemic Injured Organs and Limbs Foundation
• Hannah Jacqueline Jackson, PTA
• Kristie Lynn Jackson, NP
• Lukas Jackson, DPT
• William Materson Jackson, CRNFA
• Megan Jacobs
• Steve E Jacobs, OD
• Anne Jacobsen, LCSW
• Kari James

• Professional Counselor in Blacksburg, VA
• Providers in Blacksburg, VA by specialty
• Professional Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2025; 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.