Active NPI
Mallory Sue Jackson, LPC-A, CSC
- Professional Counselor
- Gilmer, TX
National Provider Identifier
1386513984
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 98631
- Practice address
- 359 N Cypress St Ste 102
Gilmer, TX 75644-2348 - Phone
- (903) 961-6501
- NPI assigned
- Nov 3, 2025
- Last updated
- Nov 3, 2025
- 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 | 98631 | TX | Primary |
Addresses
Primary practice location
359 N Cypress St Ste 102
Gilmer, TX 75644-2348
Mailing address
1498 W Liberty Rd
Harleton, TX 75651-3726
Phone (903) 241-1272
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 |
|---|---|---|---|
| 98631 | TX | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1762128000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1762128000000",
"number": "1386513984",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1498 W LIBERTY RD",
"city": "HARLETON",
"state": "TX",
"postal_code": "756513726",
"telephone_number": "903-241-1272"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "359 N CYPRESS ST STE 102",
"city": "GILMER",
"state": "TX",
"postal_code": "756442348",
"telephone_number": "903-961-6501"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "MALLORY",
"middle_name": "SUE",
"credential": "LPC-A, CSC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-11-03",
"last_updated": "2025-11-03",
"certification_date": "2025-11-02",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "98631",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gilmer, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.