Active NPI
Kimberly Ann Jackson, LPCC
- Counselor
- Brighton, CO
National Provider Identifier
1396159216
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 0013863
- Practice address
- 36 S 18TH Ave Ste D3
Brighton, CO 80601-2452 - Phone
- (503) 250-0510
- NPI assigned
- Jun 18, 2014
- Last updated
- Jun 18, 2014
- 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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | 0013863 | CO | Primary |
Addresses
Primary practice location
36 S 18TH Ave Ste D3
Brighton, CO 80601-2452
Mailing address
16587 Leyden St
Brighton, CO 80602-6058
Phone (503) 250-0510
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 |
|---|---|---|---|
| 0013863 | CO | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1403049600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1403049600000",
"number": "1396159216",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16587 LEYDEN ST",
"city": "BRIGHTON",
"state": "CO",
"postal_code": "806026058",
"telephone_number": "503-250-0510"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "36 S 18TH AVE STE D3",
"city": "BRIGHTON",
"state": "CO",
"postal_code": "806012452",
"telephone_number": "503-250-0510"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "KIMBERLY",
"middle_name": "ANN",
"credential": "LPCC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-06-18",
"last_updated": "2014-06-18",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "CO",
"license": "0013863",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brighton, CO
- Intermountain Medical Group Denver, LLC (Platte Valley Clinic - Diabetes & Endocrinology)
- Intermountain Medical Group Denver, LLC (Platte Valley Clinic - Maternal Fetal Medicine)
- Intermountain Medical Group Denver, LLC (Platte Valley Clinic - Spine)
- Intermountain Medical Group Denver, LLC (SCL Health Medical Group - Brighton Spine)
- Naomi Y Ito
- Alexis Ivans Janecka, FNP, WHNP
- Rachael Janoso, M.D.
- Jeffrey W. Stearns, D.M.D., M.D
- Jennifer Vogler LLC (Injury Care of Colorado Physical Therapy)
- Dayna M Jennings, CMT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 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.