Elizabeth Jackson, LPC-A

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

6927 Issued in SC

Practice address

127 W Antrim Dr
Greenville, SC 29607-2505

Phone

(864) 239-4110

NPI assigned

Jul 29, 2021

Sex

Female

Sole proprietor

No

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

Medicare enrollment (NPD)

Not 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.

• Tribe513, P.a.

  dba Vive Psych

  • Psychologist
  • Greenville, SC
  • NPI 1760016299
  NPD

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

{
    "created_epoch": "1627516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627516800000",
    "number": "1336812890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 TUMBLEWEED TER",
            "city": "TAYLORS",
            "state": "SC",
            "postal_code": "296875623",
            "telephone_number": "803-807-7345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 W ANTRIM DR",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296072505",
            "telephone_number": "864-239-4110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "LPC-A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-29",
        "last_updated": "2021-07-29",
        "certification_date": "2021-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "SC",
            "license": "6927",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carolyn E Jackson
• Charles Anthony Jackson
• Clintonia Jackson, M.D.
• Cornelia Yvette Jackson
• Denise L. Jackson, P.A.
• Hannah J Jackson
• Joanna Jackson
• Karen Mehlman Jackson, PHARMD
• Kathleen Marie Jackson, MD
• Kathryn Miles Jackson, AUD

• Mental Health Counselor in Greenville, SC
• Providers in Greenville, SC by specialty
• Mental Health Counselor in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2021; 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.