Jordan Jackson, MA, LCMHCA
Individual provider Active NPI Mental Health Counselor · Angier, NC
NPI 1194516682 · NPPES record last updated May 14, 2025
Key facts
- NPI
- 1194516682
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- A21381
- Practice address
- 800 N Raleigh St
Angier, NC 27501-8613 - Phone
- (910) 489-6994
- NPI assigned
- May 14, 2025
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A21381 | NC | MD | Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | A21381 | NC | |
| Mental Health Counselor | 101YM0800X | A21381 | Yes |
Addresses
Primary practice location
800 N Raleigh St
Angier, NC 27501-8613
Mailing address
42 Saltwater CV
Clayton, NC 27520-3665
Phone (984) 989-3566
Other providers in Angier, NC
- Rochelle Hearns
- Grace Adel Heimensen
- Lauren Hill
- Nancy Waff Hodgson
- Nancy Ikehara
- Rashanda Caprice Jackson
- Laura Horton Jessup
- Joe Hazel Counseling Services
- Jayme Kemp
- Kerr Drug Inc
All providers in Angier, NC · Mental Health Counselor in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 14, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.