Courtney Dyane Jackson

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

2425 W University Blvd
Durant, OK 74701-2942

Phone

(580) 924-7330

NPI assigned

Jan 22, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Courtney Dyane Toombs Former name

Medicare fee-for-service enrollment

Enrolled in OK

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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.

• Lighthouse Behavioral Wellness Centers

  • Community/Behavioral Health Agency
  • Ardmore, OK
  • NPI 1518997097
  Medicare reassignment NPD
• Lighthouse Behavioral Wellness Centers

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Ardmore, OK
  • NPI 1881884807
  NPD

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

{
    "created_epoch": "1579651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754524800000",
    "number": "1023648607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 189",
            "city": "ARDMORE",
            "state": "OK",
            "postal_code": "734020189",
            "telephone_number": "580-980-0674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2425 W UNIVERSITY BLVD",
            "city": "DURANT",
            "state": "OK",
            "postal_code": "747012942",
            "telephone_number": "580-924-7330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "COURTNEY",
        "middle_name": "DYANE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-22",
        "last_updated": "2025-08-07",
        "certification_date": "2025-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "COURTNEY",
            "last_name": "TOOMBS",
            "middle_name": "DYANE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Anna Belle Isaacs, BS
• Amelia Marie Isom, B.A
• Nikki Leann Jacinto, APRN
• Jayci Carol Jacks
• Brittany Dyan Jackson
• Jessica Ann Jackson
• Kendra Jackson, B.A, M.ED.
• Mary Anne Jackson
• Megan Jackson
• Ty Alan Jackson, PTA

• Mental Health Counselor in Durant, OK
• Providers in Durant, OK by specialty
• Mental Health Counselor in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2025; 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.