Active NPI
Linda L. Jackson, MAED., LPC, CGP, NCC
- Professional Counselor
- Winston Salem, NC
National Provider Identifier
1033292842
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 949
- Practice address
- 2735 Henning Dr
Winston Salem, NC 27106-4578 - Phone
- (336) 727-0504
- Fax
- (336) 748-0720
- NPI assigned
- Oct 23, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 949 | NC | Primary |
Addresses
Primary practice location
2735 Henning Dr
Winston Salem, NC 27106-4578
Mailing address
1960 Georgia Ave
Winston Salem, NC 27104-3104
Phone (336) 727-0504
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
| License | State | Type | Specialty |
|---|---|---|---|
| 949 | NC | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161561600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1033292842",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1960 GEORGIA AVE",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271043104",
"telephone_number": "336-727-0504",
"fax_number": "336-748-0720"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2735 HENNING DR",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271064578",
"telephone_number": "336-727-0504",
"fax_number": "336-748-0720"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "LINDA",
"middle_name": "L.",
"credential": "MAED., LPC, CGP, NCC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-23",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NC",
"license": "949",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Winston Salem, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.