Candice Epps Jackson, MS EDS

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

A10851 Issued in NC

Practice address

1104 S Main St Ste a
Lexington, NC 27292-3134

Phone

(704) 939-1100

NPI assigned

Dec 18, 2013

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1387324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575331200000",
    "number": "1215358254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "284 EXECUTIVE PARK DR STE 100",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280251833",
            "telephone_number": "704-939-1100",
            "fax_number": "704-939-1173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1104 S MAIN ST STE A",
            "city": "LEXINGTON",
            "state": "NC",
            "postal_code": "272923134",
            "telephone_number": "704-939-1100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "234C E Washington St",
            "address_purpose": "LOCATION",
            "city": "Greensboro",
            "state": "NC",
            "postal_code": "274012704",
            "country_code": "US",
            "telephone_number": "336-889-8800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "CANDICE",
        "middle_name": "EPPS",
        "name_prefix": "Mrs.",
        "credential": "MS EDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-18",
        "last_updated": "2019-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "A10851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Illuminate Eye Care, OD, PLLC
• Jordan Ashley Inman, MA, LPCA
• Alyssa Works Izic, DDS
• J. Gordon Wright, DDS PA
• Allana Namiah Jackson, MSW, LCSWA, LCASA
• Diamond Dandria Jackson
• Jonathan L Jackson, LPC
• Christin Jacobs, PHARMD
• Kelly Todd Jacobus, PA-C
• Andrew John Jaggernauth, MA, LPC

• Professional Counselor in Lexington, NC
• Providers in Lexington, NC by specialty
• Professional Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2019; 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.