Individual provider Active NPI

Anna Jackson, LPC-A

  • Professional Counselor
  • Dallas, TX
National Provider Identifier
1134909716
Registry record updated Oct 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
90533 Issued in TX
Practice address
12740 Hillcrest Rd Ste 210
Dallas, TX 75230-2074
Phone
(214) 394-7124
NPI assigned
Oct 2, 2023
Last updated
Oct 2, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 90533 TX Primary

Addresses

Primary practice location

12740 Hillcrest Rd Ste 210
Dallas, TX 75230-2074

Mailing address

12740 Hillcrest Rd Ste 210
Dallas, TX 75230-2074
Phone (214) 394-7124

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
90533TXMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1696204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696204800000",
    "number": "1134909716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12740 HILLCREST RD STE 210",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752302074",
            "telephone_number": "214-394-7124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12740 HILLCREST RD STE 210",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752302074",
            "telephone_number": "214-394-7124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "ANNA",
        "credential": "LPC-A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-02",
        "last_updated": "2023-10-02",
        "certification_date": "2023-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "90533",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2023; 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.