Rosalyn Eloise-Nadine Jackson, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

P1601006 Issued in AR

Practice address

110 Skyline Dr
Russellville, AR 72801-3362

Phone

(479) 967-5570

Fax

(479) 890-5364

NPI assigned

Jul 21, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AR

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

Specialty

Mental Health Counselor

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Counseling Associates IncGroup PAC ID 3173583564, 33 clinicians

Practice addresses (Care Compare)

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 and National Provider Directory roles.

• Counseling Associates Inc

  • Community/Behavioral Health Agency
  • Russellville, AR
  • NPI 1649381120

  AR

  Medicare reassignment Care Compare group NPD
• Ozark Guidance Center, Inc

  • Community/Behavioral Health Agency
  • Springdale, AR
  • NPI 1609875186

  AR

  Medicare reassignment NPD
• Counseling Associates, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Heber Springs, AR
  • NPI 1144701848
  NPD
• Ozark Guidance Center, Inc

  • Family Medicine Physician
  • Springdale, AR
  • NPI 1659945194
  NPD

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

{
    "created_epoch": "1311206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587513600000",
    "number": "1215225438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 S 48TH ST",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727626683",
            "telephone_number": "479-750-2020",
            "fax_number": "479-750-4843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 SKYLINE DR",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728013362",
            "telephone_number": "479-967-5570",
            "fax_number": "479-890-5364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "ROSALYN",
        "middle_name": "ELOISE-NADINE",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-21",
        "last_updated": "2020-04-22",
        "certification_date": "2020-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AR",
            "license": "P1601006",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AR",
            "license": "P1601006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jillian A Ison
• Keith Alan Ison, MD
• Caydee Ivey
• Julian Wade Ivy, OT
• Rebecca Iwanski, CASE MANAGER CARE CO
• Whitney Jackson, LPC
• Jenessa Jacobsen, RECOVERY ASSISTANT
• James H. Taylor D.C.PA
• Maggie James, PHD
• Jessica Jarman

• All providers in Russellville, AR
• Professional Counselor in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.