NPIMap

Individual provider Active NPI

Sharayah Christian Jackson, LPC

  • Professional Counselor
  • Columbia, SC
National Provider Identifier
1194134593
Registry record updated Oct 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
6788 Issued in SC
Practice address
1403 Calhoun St
Columbia, SC 29201-2509
Phone
(803) 727-2479
NPI assigned
Aug 11, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 6788 SC Primary

Addresses

Primary practice location

1403 Calhoun St
Columbia, SC 29201-2509

Mailing address

10120 Two Notch Road
Suite 2 Box 187
Columbia, SC 29223-3788
Phone (803) 999-6804

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL https://www.therapynotes.com/ Direct

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

LicenseStateTypeSpecialty
6788SCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Couch With Christian, LLC Professional Current Accepting new patients
Pediatrics of Newberry, LLC Past Accepting new patients
Eau Claire Cooperative Health Center, Inc. Past Accepting new patients

Locations

1403 Calhoun St
Columbia, SC 29201
Phone (803) 451-7600

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1407715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635120000000",
    "number": "1194134593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10120 TWO NOTCH ROAD",
            "address_2": "SUITE 2 BOX 187",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292233788",
            "telephone_number": "803-999-6804",
            "fax_number": "803-753-5591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1403 CALHOUN ST",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292012509",
            "telephone_number": "803-727-2479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "SHARAYAH",
        "middle_name": "CHRISTIAN",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-11",
        "last_updated": "2021-10-25",
        "certification_date": "2021-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "SC",
            "license": "6788",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://www.therapynotes.com/",
            "affiliation": "N",
            "endpointDescription": "This is the EHR used to store info and communicate with clients",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "This is a secure EHR system",
            "address_1": "1403 Calhoun St",
            "city": "Columbia",
            "state": "SC",
            "country_code": "US",
            "postal_code": "292012509",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2021; 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.