Svetlana Jackson, LAC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

A2305001 Issued in AR

Practice address

5507 W Walsh LN Ste 201
Rogers, AR 72758-8995

Phone

(479) 595-0333

NPI assigned

May 5, 2023

Last updated

May 5, 2023By the provider in NPPES

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Chenal Family Therapy, PLC

  • Mental Health Counselor
  • Little Rock, AR
  • NPI 1356604219
  NPD

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

{
    "created_epoch": "1683244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683244800000",
    "number": "1063101855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 NE ROYCE LOOP",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727123352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5507 W WALSH LN STE 201",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727588995",
            "telephone_number": "479-595-0333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "SVETLANA",
        "credential": "LAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-05",
        "last_updated": "2023-05-05",
        "certification_date": "2023-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AR",
            "license": "A2305001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chrissy Jackson, QBHP
• Luke W Jackson, LPC
• Mynhan Huynh Jackson, MD
• Natalie Ann Jackson
• Sandra Dee Jackson
• Syndey Jackson
• Dominic Amadeo Jacobelli, MD
• Tabitha Jaggers, PA
• James B Baker DO PA
• James C. Varner, D.D.S, PA

• Professional Counselor in Rogers, AR
• Providers in Rogers, AR by specialty
• Professional Counselor in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2023; 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.