Larry V Jackson Jr., LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

001738 Issued in IA

Practice address

1111 University Ave
Des Moines, IA 50314-2329

Phone

(515) 697-7982

NPI assigned

Apr 15, 2016

Sex

Male

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

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

{
    "created_epoch": "1460678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703721600000",
    "number": "1093169062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 E LANE ST TRLR 2",
            "city": "WINTERSET",
            "state": "IA",
            "postal_code": "502731772",
            "telephone_number": "563-447-7344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 UNIVERSITY AVE",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503142329",
            "telephone_number": "515-697-7982"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1420 Central Ave",
            "address_purpose": "LOCATION",
            "city": "Dubuque",
            "state": "IA",
            "postal_code": "520014842",
            "country_code": "US",
            "telephone_number": "563-451-2005",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "LARRY",
        "middle_name": "V",
        "name_suffix": "Jr.",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-15",
        "last_updated": "2023-12-28",
        "certification_date": "2023-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IA",
            "license": "001738",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carol Denise Jackson, ACADC
• Craig Jackson, B.S., C.A.D.C.
• Holli Lin Jackson
• Katie Jackson
• Kelsey A Jackson
• Megan Elizabeth Jackson, MS
• Yolanda Jackson
• Alexandrea Marie Jacob, D.O.
• Tyler Charles Jacobs-Lewis, LMHC, LPCC, CCMHC
• Warren Rupert Jacobs, LMFT

• Mental Health Counselor in Des Moines, IA
• Providers in Des Moines, IA by specialty
• Mental Health Counselor in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 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.