Tiffany Marie Jackson

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Practice address

20566 Timberlake Rd Ste a
Lynchburg, VA 24502-7221

Phone

(434) 239-4400

NPI assigned

May 13, 2021

Last updated

Jan 18, 2023By 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 VA

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

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.

• Thrive Counseling LLC

  dba Thriveworks

  • Mental Health Counselor
  • Lynchburg, VA
  • NPI 1215181300
  Medicare reassignment NPD

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

{
    "created_epoch": "1620864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674000000000",
    "number": "1205400397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "198 ELLEN DR",
            "city": "EVINGTON",
            "state": "VA",
            "postal_code": "245503587",
            "telephone_number": "757-955-5968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20566 TIMBERLAKE RD STE A",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245027221",
            "telephone_number": "434-239-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "TIFFANY",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-13",
        "last_updated": "2023-01-18",
        "certification_date": "2023-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Tiffany Jackson, FNP
• Olivia Jackson, SPECIALIST
• Pamela Sue Jackson, NP
• Rasheedah Jackson, SOCIAL WORKER
• Stephen Jackson
• William M. Jackson Jr., LPC
• Jacquelyn Jacobs, D.P.M
• Abiha Fatima Jafri, DO
• James L. Stanley, D.D.S., P.C.
• James M Peery Jr DDS PC

• Professional Counselor in Lynchburg, VA
• Providers in Lynchburg, VA by specialty
• Professional Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2023; 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.