Active NPI
Genelle Jackson
- Addiction (Substance Use Disorder) Counselor
- Marysville, WA
National Provider Identifier
1073490025
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- Practice address
- 1227 2ND St
Marysville, WA 98270-4906 - Phone
- (360) 651-2366
- NPI assigned
- Aug 20, 2025
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | WA | Primary |
Addresses
Primary practice location
1227 2ND St
Marysville, WA 98270-4906
Mailing address
23121 40TH Dr NE
Arlington, WA 98223-7677
Phone (425) 231-0709
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1755648000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1755648000000",
"number": "1073490025",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "23121 40TH DR NE",
"city": "ARLINGTON",
"state": "WA",
"postal_code": "982237677",
"telephone_number": "425-231-0709"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1227 2ND ST",
"city": "MARYSVILLE",
"state": "WA",
"postal_code": "982704906",
"telephone_number": "360-651-2366"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "GENELLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-08-20",
"last_updated": "2025-08-20",
"certification_date": "2025-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "WA",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marysville, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 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.