Melissa Jackson, LAC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

37AC00133700 Issued in NJ

Practice address

220 Jack Martin Blvd # E2
Brick, NJ 08724-7772

Phone

(732) 920-3434

NPI assigned

Feb 26, 2022

Last updated

Feb 26, 2022By the provider in NPPES

Sex

Female

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

Enrolled in NJ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Comprehensive Counseling Center LLCGroup PAC ID 4284054446, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Comprehensive Counseling Center, LLC

  • Clinical Social Worker
  • Howell, NJ
  • NPI 1821446311
  Medicare reassignment Care Compare group NPD
• Shore Psychological Healthcare LLC

  • Clinical Psychologist
  • Brick, NJ
  • NPI 1477563534
  NPD

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

{
    "created_epoch": "1645833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645833600000",
    "number": "1114673381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 JACK MARTIN BLVD # E2",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087247772",
            "telephone_number": "732-239-3427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 JACK MARTIN BLVD # E2",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087247772",
            "telephone_number": "732-920-3434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "MELISSA",
        "credential": "LAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-26",
        "last_updated": "2022-02-26",
        "certification_date": "2022-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NJ",
            "license": "37AC00133700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rosa Ital, MD
• Artur Ivchenko
• J C Orthopedic Inc
• J Townley Construction LLC
• J.C. Orthopedic Inc
• Joshua Peter Jacob, DO
• Michael A Jacobs
• Katherine Jacobus, MSW, LCSW
• Heather Jaffe
• Aneela Jafri, MD

• Mental Health Counselor in Brick, NJ
• Providers in Brick, NJ by specialty
• Mental Health Counselor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.