Individual provider Active NPI

Rebecca Elizabeth Nobles-Jackson, MED., LPC

  • Professional Counselor
  • Columbia, MO
National Provider Identifier
1255967634
Registry record updated Apr 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
2020024278 Issued in MO
Practice address
201 W Broadway Ste 2F
Columbia, MO 65203-3842
Phone
(573) 214-0436
Fax
(573) 442-0606
NPI assigned
Mar 18, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 2020024278 MO Primary

Addresses

Primary practice location

201 W Broadway Ste 2F
Columbia, MO 65203-3842

Mailing address

8300 Esters Blvd Ste 900
Irving, TX 75063-2233
Phone (415) 424-4266

Other practice location 1

10775 Pioneer Trl Ste 215
Truckee, CA 96161-0234
Phone (415) 424-4266

Other names 1

  • Rebecca Nobles Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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

Enrollment IDStateProvider typePAC IDDetails
I20240712003468 MO Practitioner - Mental Health Counselor 5496290504 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Education

State licenses

LicenseStateTypeSpecialty
2020024278MOMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Chris Lawrence and Associates, LLC. CurrentSince Apr 25, 2024 Accepting new patients

Locations

201 W Broadway
Ste 2F
Columbia, MO 65203
Phone (573) 214-0436

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1584489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682467200000",
    "number": "1255967634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8300 ESTERS BLVD STE 900",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750632233",
            "telephone_number": "415-424-4266",
            "fax_number": "415-520-6633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 W BROADWAY STE 2F",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652033842",
            "telephone_number": "573-214-0436",
            "fax_number": "573-442-0606"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10775 Pioneer Trl Ste 215",
            "address_purpose": "LOCATION",
            "city": "Truckee",
            "state": "CA",
            "postal_code": "961610234",
            "country_code": "US",
            "telephone_number": "415-424-4266",
            "fax_number": "415-520-6633",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NOBLES-JACKSON",
        "first_name": "REBECCA",
        "middle_name": "ELIZABETH",
        "credential": "MED., LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-18",
        "last_updated": "2023-04-26",
        "certification_date": "2023-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "2020024278",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REBECCA",
            "last_name": "NOBLES",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Columbia, MO

Sources for this page

Verify at the official NPI Registry.