Cynthia Jacko-Wise, LCMHCA

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

A-17431 Issued in NC

Practice address

8931 Commons Townes Dr
Raleigh, NC 27616-8084

Phone

(337) 852-8373

NPI assigned

Mar 21, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

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": "1679356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679356800000",
    "number": "1407558539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8931 COMMONS TOWNES DR",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276168084",
            "telephone_number": "337-852-8373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8931 COMMONS TOWNES DR",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276168084",
            "telephone_number": "337-852-8373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKO-WISE",
        "first_name": "CYNTHIA",
        "credential": "LCMHCA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-21",
        "last_updated": "2023-03-21",
        "certification_date": "2023-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "A-17431",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Selsabeel Jabir
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• Tamiqua Jackson Luckey, FNP-C, PMHNP-BC
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• Legarria D Jackson-Banks
• Kimberly Ann Jackson-Luzader, LPC, NCC

• Mental Health Counselor in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Mental Health Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2023; 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.