Active NPI
Lloyd Dallas Jackson, L.C.S.W.
- Mental Health Counselor
- Lexington, KY
National Provider Identifier
1144337353
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 1878
- Practice address
- 1018 E New Circle Rd
Lexington, KY 40505-4145 - Phone
- (859) 893-0146
- NPI assigned
- Aug 24, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 1878 | KY | Primary |
Addresses
Primary practice location
1018 E New Circle Rd
Lexington, KY 40505-4145
Mailing address
2455 Barnes Mill Rd
Richmond, KY 40475-9747
Phone (859) 684-5669
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1878 | KY | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156377600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1205712000000",
"number": "1144337353",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2455 BARNES MILL RD",
"city": "RICHMOND",
"state": "KY",
"postal_code": "404759747",
"telephone_number": "859-684-5669"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1018 E NEW CIRCLE RD",
"city": "LEXINGTON",
"state": "KY",
"postal_code": "405054145",
"telephone_number": "859-893-0146"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "LLOYD",
"middle_name": "DALLAS",
"name_prefix": "Mr.",
"credential": "L.C.S.W.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-24",
"last_updated": "2008-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "KY",
"license": "1878",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lexington, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.