Active NPI
Sandra G. Jackson, LPCC
- Professional Counselor
- Alamogordo, NM
National Provider Identifier
1366459778
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 0112141
- Practice address
- 1900 E. Tenth Street
Alamogordo, NM 88310 - Phone
- (575) 437-7404
- Fax
- (575) 439-2860
- NPI assigned
- Aug 1, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 0112141 | NM | Primary |
Addresses
Primary practice location
1900 E. Tenth Street
Alamogordo, NM 88310
Mailing address
1320 S. Solano
Las Cruces, NM 88001
Phone (575) 527-7900
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 94206708 | Medicaid | NM | |
| 18677037 | Medicaid | NM |
Other names 1
- Sandra Lewis
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0112141 | NM | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154390400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1396051200000",
"number": "1366459778",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1320 S. SOLANO",
"city": "LAS CRUCES",
"state": "NM",
"postal_code": "88001",
"telephone_number": "575-527-7900",
"fax_number": "575-571-4872"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1900 E. TENTH STREET",
"city": "ALAMOGORDO",
"state": "NM",
"postal_code": "88310",
"telephone_number": "575-437-7404",
"fax_number": "575-439-2860"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "SANDRA",
"middle_name": "G.",
"name_prefix": "Mrs.",
"credential": "LPCC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-01",
"last_updated": "2014-03-29",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NM",
"license": "0112141",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "94206708",
"state": "NM"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "18677037",
"state": "NM"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "SANDRA",
"last_name": "LEWIS",
"credential": "LPCC",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Alamogordo, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.