Jackson Behavioral Health Professionals, PLLC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

KY0480 Issued in KY

Legal business name

JACKSON BEHAVIORAL HEALTH PROFESSIONALS, PLLC

Practice address

1013 Master St
Corbin, KY 40701-1065

Phone

(606) 526-9500

Fax

(606) 526-8080

NPI assigned

Nov 19, 2006

Organization subpart

No

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

Authorized official

Name

Mr. William Matt Ellison, LCSW

Title

Proprietor

Phone

(606) 526-9500

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1163894400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1336213784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2343",
            "city": "LONDON",
            "state": "KY",
            "postal_code": "407432343",
            "telephone_number": "606-526-9500",
            "fax_number": "606-526-8080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1013 MASTER ST",
            "city": "CORBIN",
            "state": "KY",
            "postal_code": "407011065",
            "telephone_number": "606-526-9500",
            "fax_number": "606-526-8080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON BEHAVIORAL HEALTH PROFESSIONALS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-19",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "ELLISON",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "MATT",
        "authorized_official_title_or_position": "PROPRIETOR",
        "authorized_official_telephone_number": "606-526-9500",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "KY",
            "license": "KY0480",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "KY1625",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pattie Nicole Isaacs, BS
• Diana Ison, CPSS
• Mariah Jean Jackson-Arnett, MD
• Breanna Renee Jackson, PHARMD
• Candace Camille Jackson, BA
• Debra Jackson
• Kayla Ann Jackson, BS

• Addiction (Substance Use Disorder) Counselor in Corbin, KY
• Providers in Corbin, KY by specialty
• Addiction (Substance Use Disorder) Counselor in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.