Active NPI
Robin Joelle Jackson, LPC
- Professional Counselor
- Manassas, VA
National Provider Identifier
1104414937
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 0701010156
- Practice address
- 7969 Ashton Ave
Manassas, VA 20109-2885 - Phone
- (703) 792-7800
- Fax
- (703) 792-5699
- NPI assigned
- Jan 7, 2021
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 0701010156 | VA | Primary |
Addresses
Primary practice location
7969 Ashton Ave
Manassas, VA 20109-2885
Mailing address
7969 Ashton Ave
Manassas, VA 20109-2885
Phone (703) 792-7800
Other names 1
- Robin Joelle Jackson
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0701010156 | VA | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1609977600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1609977600000",
"number": "1104414937",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7969 ASHTON AVE",
"city": "MANASSAS",
"state": "VA",
"postal_code": "201092885",
"telephone_number": "703-792-7800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7969 ASHTON AVE",
"city": "MANASSAS",
"state": "VA",
"postal_code": "201092885",
"telephone_number": "703-792-7800",
"fax_number": "703-792-5699"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "ROBIN",
"middle_name": "JOELLE",
"name_prefix": "Mrs.",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-01-07",
"last_updated": "2021-01-07",
"certification_date": "2021-01-07",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "VA",
"license": "0701010156",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "ROBIN",
"last_name": "JACKSON",
"middle_name": "JOELLE",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Manassas, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2021; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.