Jade Clinical Supervision and Consultation, LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

JADE CLINICAL SUPERVISION AND CONSULTATION, LLC

Practice address

4780 I 55 Frontage Rd N Ste 100-1204
Jackson, MS 39211-5542

Phone

(601) 331-6767

Fax

(601) 861-4909

NPI assigned

Mar 12, 2024

Last updated

Aug 21, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Miss Jessica Thomas, LPC-SNPI 1477918043

Title

Owner/Operator/Ceo

Phone

(601) 331-6767

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jessica Denise Thomas, LPC, NCC, CTTS

  • Professional Counselor
  • Jackson, MS
  • NPI 1477918043
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1710201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724198400000",
    "number": "1427816644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4780 I 55 FRONTAGE RD N STE 100-1204",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392115542",
            "telephone_number": "601-331-6767",
            "fax_number": "601-861-4909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4780 I 55 FRONTAGE RD N STE 100-1204",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392115542",
            "telephone_number": "601-331-6767",
            "fax_number": "601-861-4909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JADE CLINICAL SUPERVISION AND CONSULTATION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-12",
        "last_updated": "2024-08-21",
        "certification_date": "2024-08-21",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "OWNER/OPERATOR/CEO",
        "authorized_official_telephone_number": "601-331-6767",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "LPC-S"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Terica Herron Jackson, M.D.
• Tissan Tilden Jackson, LCSW
• Tonya Jackson, MT-BC
• Marvin Jacob
• Sebastian John Jacobi, D.O.
• Navkiran Singh Jagdev, MD
• Rani Jagwani, LMFT
• Tina Jagwani
• Sarika Prakash Jain, M.D.
• Jaisiri Jaiwatana, M.D.

• Professional Counselor in Jackson, MS
• Providers in Jackson, MS by specialty
• Professional Counselor in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2024; 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.