Christopher Jackson, LMHC

Primary specialty

CounselorTaxonomy code 101Y00000X

License

008069 Issued in NY

Practice address

104-70 Queens Blvd
Forest Hills, NY 11375

Phone

(718) 275-6010

NPI assigned

Aug 18, 2017

Sex

Male

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

Practice roles

Interoperability endpoints

• FHIR API: https://api.qualifacts.org/api/fhir/bleulerpc/r4/

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.

• Bleuler Psychotherapy Center, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Forest Hills, NY
  • NPI 1801949706
  NPD (past)

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

{
    "created_epoch": "1503014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1093231284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 E MAIN ST",
            "city": "PATCHOGUE",
            "state": "NY",
            "postal_code": "117723121",
            "telephone_number": "516-363-2001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104-70 QUEENS BLVD",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "11375",
            "telephone_number": "718-275-6010"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "475 E Main St",
            "address_purpose": "LOCATION",
            "city": "Patchogue",
            "state": "NY",
            "postal_code": "117723121",
            "country_code": "US",
            "telephone_number": "516-363-2001 x1427",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "CHRISTOPHER",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-08-18",
        "last_updated": "2022-07-21",
        "certification_date": "2020-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NY",
            "license": "008069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ja Gohar Medical
• Sarah Sigalit Jabbour, PSY.D.
• Kathryn Jablon
• Carla Jack, LMHC
• Camille Jackson
• Kamala Eva-Marie Jackson, LMSW
• Lauryn Williams Jackson, LMSW
• Melanie Jackson, PA-C
• Adam Jacob, DO
• Flora Jacobson, L.C.S.W.

• Counselor in Forest Hills, NY
• Providers in Forest Hills, NY by specialty
• Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.