Melanie J Jackson, MS, LMHC, NCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

18548 Issued in TX

Practice address

5840 Red Bug Lake Rd
#1548
Winter Springs, FL 32708-5011

Phone

(423) 342-6422

Fax

(407) 695-8803

NPI assigned

Jun 29, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Networks

• NM HMO C-SNP
• FL HMO
• TX HMO D-SNP
• AL HMO D-SNP
• devoted network organization-d5084670-562f-408b-b100-22a1a4ef4d82
• FL HMO C-SNP
• TX HMO
• devoted network organization-14bfd35d-d818-4696-813b-340339e464ef
• devoted network organization-25ba88d3-d0a6-4213-84f1-eef6f2b59f68
• FL HMO D-SNP
• AL HMO

Interoperability endpoints

• Direct secure messaging: melaniejackson@tdh.allscriptsdirect.net

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.

• Teladoc Health Medical Group, P.a.

  • Family Medicine Physician
  • Lewisville, TX
  • NPI 1245403567

  Counselor

  NPD

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

{
    "created_epoch": "1277769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591574400000",
    "number": "1013228600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5840 RED BUG LAKE RD",
            "address_2": "#1548",
            "city": "WINTER SPRINGS",
            "state": "FL",
            "postal_code": "327085011",
            "telephone_number": "423-342-6422",
            "fax_number": "407-695-8803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5840 RED BUG LAKE RD",
            "address_2": "#1548",
            "city": "WINTER SPRINGS",
            "state": "FL",
            "postal_code": "327085011",
            "telephone_number": "423-342-6422",
            "fax_number": "407-695-8803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "MELANIE",
        "middle_name": "J",
        "credential": "MS, LMHC, NCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-29",
        "last_updated": "2020-06-08",
        "certification_date": "2020-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH 3045",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NC",
            "license": "NCC 33945",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "18548",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "www.doximity.com",
            "affiliation": "N",
            "endpointDescription": "Doximity",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "5840 Red Bug Lake Rd",
            "address_2": "#1548",
            "city": "Winter Springs",
            "state": "FL",
            "country_code": "US",
            "postal_code": "327085011",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Mary Rose Isaacs, D.M.D.
• K Rose Ivey, LMT (FL)
• J Jeffrey Bos D C P a
• J. Jeffrey Bos, D.C., P.a.
• Lindsay Jackson-Drago
• Monica V. Jackson, FS
• Jaime Thony PA
• Jakubowski Sports Rehabilitation, LLC
• Jam Specailized Healthcare, Inc
• James Adam McCracken, PH.D., LLC

• Professional Counselor in Winter Springs, FL
• Providers in Winter Springs, FL by specialty
• Professional Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.