Active NPI
Mary Jackson, MS
- Professional Counselor
- McKinney, TX
National Provider Identifier
1477282705
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 83449
- Practice address
- 114 E Louisiana St Ste 201
McKinney, TX 75069-4463 - Phone
- (972) 850-6674
- NPI assigned
- Jun 10, 2022
- Last updated
- Jun 10, 2022
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 83449 | TX | Primary |
Addresses
Primary practice location
114 E Louisiana St Ste 201
McKinney, TX 75069-4463
Mailing address
114 E Louisiana St Ste 201
McKinney, TX 75069-4463
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Feb 12, 2024 through Feb 12, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 83449 | TX | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1654819200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1654819200000",
"number": "1477282705",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "114 E LOUISIANA ST STE 201",
"city": "MCKINNEY",
"state": "TX",
"postal_code": "750694463"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "114 E LOUISIANA ST STE 201",
"city": "MCKINNEY",
"state": "TX",
"postal_code": "750694463",
"telephone_number": "972-850-6674"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "MARY",
"credential": "MS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-06-10",
"last_updated": "2022-06-10",
"certification_date": "2022-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "83449",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in McKinney, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2022; 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.