Active NPI
Deidre Co'Llett Jackson, M.ED LPC
- Professional Counselor
- Houston, TX
National Provider Identifier
1376944538
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 66355
- Practice address
- 1826 Lingard Park CT
Houston, TX 77047-7514 - Phone
- (713) 301-7461
- NPI assigned
- Sep 8, 2014
- Sex
- Female
- Sole proprietor
- Yes
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 | 66355 | TX | Primary |
Addresses
Primary practice location
1826 Lingard Park CT
Houston, TX 77047-7514
Mailing address
5959 West Loop S Ste 367
Bellaire, TX 77401-2420
Phone (713) 301-7461
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1410134400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1410134400000",
"number": "1376944538",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5959 WEST LOOP S STE 367",
"city": "BELLAIRE",
"state": "TX",
"postal_code": "774012420",
"telephone_number": "713-301-7461"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1826 LINGARD PARK CT",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770477514",
"telephone_number": "713-301-7461"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "DEIDRE",
"middle_name": "CO'LLETT",
"credential": "M.ED LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-09-08",
"last_updated": "2014-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "66355",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 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.