Sherry Danielle Jackson, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

3790 Issued in AL

Practice address

6301 S Clubview Cir
Bessemer, AL 35022-7041

Phone

(205) 657-3137

NPI assigned

Jul 22, 2019

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: sherryjackson@tdh.allscriptsdirect.net

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.

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  Professional

  NPD
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  NPD (past)

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

{
    "created_epoch": "1563753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563753600000",
    "number": "1215580931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6301 S CLUBVIEW CIR",
            "city": "BESSEMER",
            "state": "AL",
            "postal_code": "350227041",
            "telephone_number": "205-657-3137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6301 S CLUBVIEW CIR",
            "city": "BESSEMER",
            "state": "AL",
            "postal_code": "350227041",
            "telephone_number": "205-657-3137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "SHERRY",
        "middle_name": "DANIELLE",
        "name_prefix": "Miss",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-22",
        "last_updated": "2019-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AL",
            "license": "3790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Courtney Issis-Banuelos, CRNP
• John Odeh Issis, M.D.
• J.R. Moore & Associates LLC
• Garrett Jackson, DO
• Janita Roshell Jackson
• James C Rains Jr MD PC
• JBC Counseling & Consulting LLC
• Jefferson Health System Pharmacy #3
• Jamyah Destinee Jemison, PHARMD
• Jerry McLane Internal Medicine LLC

• Professional Counselor in Bessemer, AL
• Providers in Bessemer, AL by specialty
• Professional Counselor in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2019; 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.