Brianna Jackson, LPC

Primary specialty

CounselorTaxonomy code 101Y00000X

License

178.020373 Issued in IL

Practice address

7300 W College Dr Ste 203
Palos Heights, IL 60463-1183

Phone

(708) 488-7848

NPI assigned

Aug 28, 2024

Last updated

Aug 28, 2024By the provider in NPPES

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

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1724803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724803200000",
    "number": "1356175889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18653 BERNADINE ST",
            "city": "LANSING",
            "state": "IL",
            "postal_code": "604383506",
            "telephone_number": "708-822-3575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7300 W COLLEGE DR STE 203",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604631183",
            "telephone_number": "708-488-7848"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18653 Bernadine St",
            "address_purpose": "LOCATION",
            "city": "Lansing",
            "state": "IL",
            "postal_code": "604383506",
            "country_code": "US",
            "telephone_number": "708-822-3575",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "BRIANNA",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-28",
        "last_updated": "2024-08-28",
        "certification_date": "2024-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "IL",
            "license": "178.020373",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Counselor in Palos Heights, IL
• Providers in Palos Heights, IL by specialty
• Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2024; 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.