Trinicia Renee Lavon Jackson, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

7802 Issued in SC

Practice address

1105 Belleview St Ste 103
Columbia, SC 29201-1839

Phone

(803) 250-5570

NPI assigned

Jul 2, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

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.

• Pieces 2 Peace Wellness & Consulting LLC

  • Mental Health Counselor
  • Columbia, SC
  • NPI 1346093309
  NPD Authorized official
• Pieces 2 Peace Wellness Center, LLC

  • Mental Health Counselor
  • Columbia, SC
  • NPI 1902403116
  NPD

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

{
    "created_epoch": "1593648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631145600000",
    "number": "1033736202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6530 DAVIDSON ST APT C1",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292091732",
            "telephone_number": "803-447-3949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 BELLEVIEW ST STE 103",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292011839",
            "telephone_number": "803-250-5570"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6530 Davidson St Apt C1",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "SC",
            "postal_code": "292091732",
            "country_code": "US",
            "telephone_number": "803-846-2499",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "TRINICIA",
        "middle_name": "RENEE LAVON",
        "name_prefix": "Miss",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-02",
        "last_updated": "2021-09-09",
        "certification_date": "2021-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "SC",
            "license": "7802",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "SC",
            "license": "7112",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PC2451",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephanie Jackson
• Susan L Jackson, RN, MPH
• Tomeka Nichole Jackson, FNP-C
• Tonda P Jackson, FNP
• Trevor Brandon Jackson, MT
• Tushmbay Lateef Jackson
• Jacobs Perspective Community Care Services
• Jacobs Transportation Service LLC
• Alexis Jacobs
• Dean Robert Jacobs, MD

• Mental Health Counselor in Columbia, SC
• Providers in Columbia, SC by specialty
• Mental Health Counselor in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2021; 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.