Tracee Louise Jackson, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

6401011830 Issued in MI

Practice address

22901 W Industrial Dr Ste 105
Saint Clair Shores, MI 48080-1130

Phone

(313) 980-1254

NPI assigned

Oct 25, 2012

Last updated

Jun 25, 2025By 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 MI

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, 2009

Medicare assignment

May accept Medicare assignment

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.

• Endless Possibilities Counseling Clinic LLC

  • Community/Behavioral Health Agency
  • Saint Clair Shores, MI
  • NPI 1063281418
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1351123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750809600000",
    "number": "1144573338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "482 ALLARD AVE",
            "city": "GROSSE POINTE FARMS",
            "state": "MI",
            "postal_code": "482362812",
            "telephone_number": "313-980-1254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22901 W INDUSTRIAL DR STE 105",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480801130",
            "telephone_number": "313-980-1254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "TRACEE",
        "middle_name": "LOUISE",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-25",
        "last_updated": "2025-06-25",
        "certification_date": "2025-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6401011830",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Denise M Jabbour, DO
• Jack Failla D.C.P.C.
• Jackie Placidi MSW, LMSW
• N'Gozi Sahrel Jackson
• Nija Jackson, RBT
• David Jacobs
• Jonathan H Jacobs, D.D.S.
• Leah Michelle Jacobs, DDS
• Rita Saleem Jaddou, M.D.
• Sara Jajo

• Mental Health Counselor in Saint Clair Shores, MI
• Providers in Saint Clair Shores, MI by specialty
• Mental Health Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2025; 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.