Derda Jackson, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH21947 Issued in FL

Practice address

10752 Deerwood Park Blvd Ste 100
Jacksonville, FL 32256-4846

Phone

(904) 776-1061

NPI assigned

Apr 7, 2023

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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 and National Provider Directory roles.

• Transformation Counseling Services, LLC

  • Mental Health Counselor
  • Jacksonville, FL
  • NPI 1679451454
  NPD Authorized official

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

{
    "created_epoch": "1680825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760227200000",
    "number": "1154016863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10752 DEERWOOD PARK BLVD STE 100",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322564846",
            "telephone_number": "904-776-1061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10752 DEERWOOD PARK BLVD STE 100",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322564846",
            "telephone_number": "904-776-1061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "DERDA",
        "name_prefix": "Ms.",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-04-07",
        "last_updated": "2025-10-12",
        "certification_date": "2025-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH21947",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Corinne Jackson, MOT, OTR/L
• Corinne Sokolik Jackson, M.D.
• Courtney Carson Jackson
• Curtis Earl Jackson
• Demika Jackson
• Don Benard Jackson Jr., B.A.
• Ebony Jackson
• Elizabeth Denise Jackson, LPN
• Gerald Derand Jackson
• Helen D Jackson, LD/N

• Mental Health Counselor in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 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.