Emily Jackson

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

0701998652 Issued in VA

Practice address

101 Buford Rd Ste 110
North Chesterfield, VA 23235-5292

Phone

(804) 447-6382

NPI assigned

Sep 18, 2019

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

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Chesterfield Family Guidance Center

  • Clinical Psychologist
  • Richmond, VA
  • NPI 1225192909

  Professional

  NPD
• Lighthouse Behavioral Health Center, LLC

  • Community/Behavioral Health Agency
  • North Chesterfield, VA
  • NPI 1982952545

  Professional

  NPD

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

{
    "created_epoch": "1568764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568764800000",
    "number": "1437709888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2106 FLOYD AVE",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232204532",
            "telephone_number": "540-797-3675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 BUFORD RD STE 110",
            "city": "NORTH CHESTERFIELD",
            "state": "VA",
            "postal_code": "232355292",
            "telephone_number": "804-447-6382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "EMILY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-18",
        "last_updated": "2019-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701998652",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Varvara Isaieva
• Amir Mahmoud Ismail
• Elden Paul Iverson, MD
• J&M Adult Care Services, LLC
• Angelette Jackson, NP
• Hannah Kioko Jackson
• John Martin Jackson
• Naomi Martina Jackson, LCSW
• Quatysha N Jackson, LCSW
• Harvey Earl Jacobs, PH.D.

• Professional Counselor in North Chesterfield, VA
• Providers in North Chesterfield, VA by specialty
• Professional Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.