Joshua Dean Jackson

Primary specialty

Social WorkerTaxonomy code 104100000X

License

13479 Issued in KS

Practice address

500 Main Place, 500 N Main St Ste 156
Newton, KS 67114

Phone

(316) 202-4414

NPI assigned

Mar 14, 2024

Last updated

Mar 14, 2024By the provider in NPPES

Sex

Male

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

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.

• Friesen Counseling Services LLC

  • Clinical Social Worker
  • Newton, KS
  • NPI 1992216303
  NPD (past)

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

{
    "created_epoch": "1710374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710374400000",
    "number": "1164281085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 BROOKSIDE DR",
            "city": "NEWTON",
            "state": "KS",
            "postal_code": "671144612",
            "telephone_number": "580-512-0053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 MAIN PLACE, 500 N MAIN ST STE 156",
            "city": "NEWTON",
            "state": "KS",
            "postal_code": "67114",
            "telephone_number": "316-202-4414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "JOSHUA",
        "middle_name": "DEAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-03-14",
        "last_updated": "2024-03-14",
        "certification_date": "2024-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "KS",
            "license": "13479",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy E. Ibbetson
• Carolyn Ingersoll
• Shelly Ann Ingram, MS, LCMFT
• Integrity Medicine LLC
• Alayna Irwin
• Selena Jackson, MS
• Michele I Janssens, SLP
• Jonathan W Jantz, MD, FAAP
• Michael Janzen, LMSW
• Zora Genevieve Jenney, MD

• Social Worker in Newton, KS
• Providers in Newton, KS by specialty
• Social Worker in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2024; 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.