Active NPI
Vickie Lee Jackson
- Mental Health Counselor
- Milwaukee, WI
National Provider Identifier
1407161599
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 564-226
- Practice address
- 7809 W Beckett Ave
Milwaukee, WI 53218-5320 - Phone
- (414) 535-9892
- Fax
- (414) 535-9892
- NPI assigned
- Aug 12, 2010
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 564-226 | WI | Primary |
Addresses
Primary practice location
7809 W Beckett Ave
Milwaukee, WI 53218-5320
Mailing address
7809 W Beckett Ave
Milwaukee, WI 53218-5320
Phone (414) 535-9892
Other names 1
- Ms. Vickie L Jackson
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 |
|---|---|---|---|
| 564-226 | WI | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1281571200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1281571200000",
"number": "1407161599",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7809 W BECKETT AVE",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532185320",
"telephone_number": "414-535-9892",
"fax_number": "414-535-9892"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7809 W BECKETT AVE",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532185320",
"telephone_number": "414-535-9892",
"fax_number": "414-535-9892"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "VICKIE",
"middle_name": "LEE",
"name_prefix": "Ms.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-08-12",
"last_updated": "2010-08-12",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "WI",
"license": "564-226",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "VICKIE",
"last_name": "JACKSON",
"middle_name": "L",
"prefix": "MS.",
"credential": "LPC",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Milwaukee, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.