Kirsten Tamara Jackson, LCPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LC17136 Issued in MD

Practice address

9565 Sylvan Still Rd
Laurel, MD 20723-1540

Phone

(240) 354-7446

NPI assigned

Apr 3, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Grace Carries Wellness Collaborative and Consulting

  • Counselor
  • Laurel, MD
  • NPI 1649100991
  NPD Authorized official

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

{
    "created_epoch": "1712102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760918400000",
    "number": "1033961990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9565 SYLVAN STILL RD APT Q",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207231540",
            "telephone_number": "240-354-7446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9565 SYLVAN STILL RD",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207231540",
            "telephone_number": "240-354-7446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "KIRSTEN",
        "middle_name": "TAMARA",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-04-03",
        "last_updated": "2025-10-20",
        "certification_date": "2025-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": "LC17136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anita Rikki Jackson, MSED, BCBA
• Ayesha Iman Jackson, OT
• Breana M Jackson, PTA
• Deborah A Jackson
• Frank R. Jackson, M.D.
• Kiti Jackson
• Naima K Jackson, PA-C
• Nkolika Jackson, PT
• Shonta Jackson
• Steven Matt Jacques

• Mental Health Counselor in Laurel, MD
• Providers in Laurel, MD by specialty
• Mental Health Counselor in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 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.