Luke W Jackson, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

P2208022 Issued in AR

Practice address

2108 S 54TH St Ste 3
Rogers, AR 72758-8125

Phone

(817) 201-5846

NPI assigned

Dec 21, 2020

Last updated

Dec 6, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

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": "1608508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670284800000",
    "number": "1376139642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 LEICESTER DR",
            "city": "BELLA VISTA",
            "state": "AR",
            "postal_code": "727144100",
            "telephone_number": "817-201-5846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2108 S 54TH ST STE 3",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727588125",
            "telephone_number": "817-201-5846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "LUKE",
        "middle_name": "W",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-12-21",
        "last_updated": "2022-12-06",
        "certification_date": "2022-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": "A2011175",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AR",
            "license": "P2208022",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Randall Ray Ironside, PT
• James P Irwin, DO
• Stephen Alexander Irwin, M.D.
• Gary Ivey, PD
• Chrissy Jackson, QBHP
• Mynhan Huynh Jackson, MD
• Natalie Ann Jackson
• Sandra Dee Jackson
• Svetlana Jackson, LAC
• Syndey Jackson

• Mental Health Counselor in Rogers, AR
• Providers in Rogers, AR by specialty
• Mental Health Counselor in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2022; 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.