NPIMap

Organization Active NPI

Jackson Healing

  • Clinic/Center
  • Jackson, MI
National Provider Identifier
1114738499
Registry record updated Jan 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
JACKSON HEALING
Practice address
720 W Franklin St
Jackson, MI 49201-1674
Phone
(734) 726-4038
Fax
(517) 905-5906
NPI assigned
Jan 16, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2025

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

Authorized official

Name
Heather Renee Goolsby, MA, LPC, NCC, CPT-C
Title
Master Clinicican
Phone
(517) 581-4710

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X
Clinic/Center 261Q00000X Primary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Adult Mental Health Clinic/Center 261QM0850X
Adolescent and Children Mental Health Clinic/Center 261QM0855X

Addresses

Primary practice location

720 W Franklin St
Jackson, MI 49201-1674

Mailing address

2020 Cascade Dr
Jackson, MI 49203-3810
Phone (517) 581-4710

Other practice location 1

126 Seymour Ave
Jackson, MI 49202-3558
Phone (734) 726-4038

National Provider Directory

National Provider Directory

Locations

126 Seymour Ave
Jackson, MI 49202
Phone (734) 219-3314

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1736985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736985600000",
    "number": "1114738499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 CASCADE DR",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492033810",
            "telephone_number": "517-581-4710",
            "fax_number": "517-905-5906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 W FRANKLIN ST",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011674",
            "telephone_number": "734-726-4038",
            "fax_number": "517-905-5906"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "126 Seymour Ave",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "MI",
            "postal_code": "492023558",
            "country_code": "US",
            "telephone_number": "734-726-4038",
            "fax_number": "517-905-5906",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "JACKSON HEALING",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-16",
        "last_updated": "2025-01-16",
        "certification_date": "2025-01-16",
        "status": "A",
        "authorized_official_last_name": "GOOLSBY",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_middle_name": "RENEE",
        "authorized_official_title_or_position": "MASTER CLINICICAN",
        "authorized_official_telephone_number": "517-581-4710",
        "authorized_official_credential": "MA, LPC, NCC, CPT-C"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2025; 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.