Heather Jackson, LMHC

Primary specialty

CounselorTaxonomy code 101Y00000X

License

MH 14095 Issued in FL

Practice address

107 Amar PL Ste 102
Panama City Beach, FL 32413-5014

Phone

(850) 419-7736

Fax

(850) 328-4010

NPI assigned

May 18, 2016

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

Medicare fee-for-service enrollment

Enrolled in FL

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

Specialty

Mental Health Counselor

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

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.

• Heather Jackson, Ms, LMHC, LLC

  • Counselor
  • Santa Rosa Beach, FL
  • NPI 1013364132
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1463529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689724800000",
    "number": "1053768176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "256 CARSON OAKS LN",
            "city": "SANTA ROSA BEACH",
            "state": "FL",
            "postal_code": "324597149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 AMAR PL STE 102",
            "city": "PANAMA CITY BEACH",
            "state": "FL",
            "postal_code": "324135014",
            "telephone_number": "850-419-7736",
            "fax_number": "850-328-4010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "HEATHER",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-18",
        "last_updated": "2023-07-19",
        "certification_date": "2023-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "FL",
            "license": "MH 14095",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shea Kristen Irvine
• Sheyda Isazadeh-Khaylani, DC
• J Grant Shuflitowski MD PA Gulf View Family Medical Center
• J L L MD Inc
• Deaundra Brisha Jackson, M.A
• Renese Jackson, PHARMD
• Thomas Albert Jacobson, M.D.
• Timothy Scott Jarrett
• Jessica Jaworski, ARNP, NP-C
• Salena Jerkins, ARNP FNP-C

• Counselor in Panama City Beach, FL
• Providers in Panama City Beach, FL by specialty
• Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.