Robin Jackson, LAC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

A1908012 Issued in AR

Practice address

3111 S 70TH St
Fort Smith, AR 72903-5017

Phone

(479) 452-6650

Fax

(479) 452-5847

NPI assigned

May 20, 2016

Sex

Female

Sole proprietor

No

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

Opted out of Medicare

Yes, effective Jun 27, 2024 through Jun 27, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• The Whitson Group, LLC

  • Mental Health Counselor
  • Fort Smith, AR
  • NPI 1144881707
  NPD (past)

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

{
    "created_epoch": "1463702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565654400000",
    "number": "1447607205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11818",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729171818",
            "telephone_number": "479-452-6650",
            "fax_number": "479-452-5847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3111 S 70TH ST",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729035017",
            "telephone_number": "479-452-6650",
            "fax_number": "479-452-5847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "ROBIN",
        "credential": "LAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-20",
        "last_updated": "2019-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AR",
            "license": "A1908012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carolyn Jackson
• Janissa D Jackson, PHD
• Jennifer Jackson, RDS, CIT
• McKenzie Alexandra Jackson, MD
• Michael Jackson, QBHP
• Tyler Joshua Jackson
• Curtsie Jacobs
• Jacqueline Goldsmith Phillips PLLC
• Jouma Jalou
• James B. Saviers D.D.S., P.a.

• Mental Health Counselor in Fort Smith, AR
• Providers in Fort Smith, AR by specialty
• Mental Health Counselor in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.