Individual provider Active NPI

Jackson Irving Michener, LMHCA

  • Mental Health Counselor
  • Seattle, WA
National Provider Identifier
1104763481
Registry record updated May 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MHCA.MC.61691478 Issued in WA
Practice address
7201 6TH Ave NE Apt 101
Seattle, WA 98115-8613
Phone
(763) 482-3013
NPI assigned
May 4, 2026
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 4, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MHCA.MC.61691478 WA Primary

Addresses

Primary practice location

7201 6TH Ave NE Apt 101
Seattle, WA 98115-8613

Mailing address

7201 6TH Ave NE Apt 101
Seattle, WA 98115-8613

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

State licenses

LicenseStateTypeSpecialty
MHCA.MC.61691478WAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1777852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777852800000",
    "number": "1104763481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7201 6TH AVE NE APT 101",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981158613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7201 6TH AVE NE APT 101",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981158613",
            "telephone_number": "763-482-3013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICHENER",
        "first_name": "JACKSON",
        "middle_name": "IRVING",
        "credential": "LMHCA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-05-04",
        "last_updated": "2026-05-04",
        "certification_date": "2026-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "MHCA.MC.61691478",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2026; 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.