Damaria Emaune Jackson, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

2204717 Issued in OH

Practice address

10861 Yankee St
Dayton, OH 45458-3574

Phone

(937) 619-0800

NPI assigned

Feb 7, 2018

Last updated

Dec 9, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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 OH

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

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.

• Mindfully, LLC

  dba Compass Point Counseling Services

  • Counselor
  • Fairfield, OH
  • NPI 1972702520

  Mental Health

  Medicare reassignment NPD
• Mindfully, LLC

  • Counselor
  • Jacksonville, FL
  • NPI 1376271981

  Mental Health

  NPD

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

{
    "created_epoch": "1517961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670544000000",
    "number": "1194224923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1522 N MAIN ST APT A",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454054152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10861 YANKEE ST",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454583574",
            "telephone_number": "937-619-0800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "DAMARIA",
        "middle_name": "EMAUNE",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-07",
        "last_updated": "2022-12-09",
        "certification_date": "2022-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "2204717",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carroll S Jackson, L.I.S.W.
• Chinah Lynn Jackson
• Courtney Faith Jackson
• Courtney L Jackson, SWA
• Cynthia Jackson, R.N. CDE
• Danielle Elizabeth Jackson, DPT
• Darryeon Jackson
• Dawanya Jackson
• Deborah Gail Jackson, LMT
• Deborah M Jackson, CARE GIVER

• Mental Health Counselor in Dayton, OH
• Providers in Dayton, OH by specialty
• Mental Health Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.