Jackson Psychotherapy, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

JACKSON PSYCHOTHERAPY, LLC

Doing business as

The Satori Program

Practice address

901 Kentucky St Ste 306
Lawrence, KS 66044-2858

Phone

(816) 377-7398

Fax

(816) 873-1364

NPI assigned

Aug 7, 2017

Organization subpart

No

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

Authorized official

Name

Reginald C. Jackson, LSCSW, LCSW

Title

Owner/Executive Director

Phone

(816) 377-7398

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• The Satori Program Doing business as

Tax ID family

Jackson Psychotherapy LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Jackson Psychotherapy, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Lawrence, KS
  • NPI 1578064861
  NPD tax ID

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

{
    "created_epoch": "1502064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1154846533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 KENTUCKY ST STE 306",
            "city": "LAWRENCE",
            "state": "KS",
            "postal_code": "660442858",
            "telephone_number": "816-377-7398",
            "fax_number": "816-873-1364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 KENTUCKY ST STE 306",
            "city": "LAWRENCE",
            "state": "KS",
            "postal_code": "660442858",
            "telephone_number": "816-377-7398",
            "fax_number": "816-873-1364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON PSYCHOTHERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-07",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "REGINALD",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "OWNER/EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "816-377-7398",
        "authorized_official_credential": "LSCSW, LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200629810C",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Satori Program",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Inzerillo Family Practice, LLC
• Iowa Street Dental Group, P.a. (Iowa Street Dental Group)
• Hong U. Ishaku
• Shelby Lynn Jack, M.S., CCC-SLP
• Rachel Leigh Jackson Meier, LIMHP, LMHP, LCPC
• Jackson Psychotherapy, LLC
• Heather Jackson, LPC
• Kaela Jackson, COTA/L
• Reginald Christopher Jackson, LSCSW
• Jacob Schmill Counseling LLC

• Clinical Social Worker in Lawrence, KS
• Providers in Lawrence, KS by specialty
• Clinical Social Worker in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.