Janelle L Jackson

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

5601 Democracy Dr Ste 135
Plano, TX 75024-3672

Phone

(501) 944-0931

NPI assigned

Jun 7, 2013

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

Enrolled in TX

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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.

• Blank Slate Therapy

  • Professional Counselor
  • Frisco, TX
  • NPI 1639539364
  Medicare reassignment NPD

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

{
    "created_epoch": "1370563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588550400000",
    "number": "1477991818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5601 DEMOCRACY DR STE 135",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750243672",
            "telephone_number": "479-464-1060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5601 DEMOCRACY DR STE 135",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750243672",
            "telephone_number": "501-944-0931"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 W Walnut St",
            "address_2": "Ste 3100",
            "address_purpose": "LOCATION",
            "city": "Rogers",
            "state": "AR",
            "postal_code": "727563521",
            "country_code": "US",
            "telephone_number": "479-631-9996",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "JANELLE",
        "middle_name": "L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-07",
        "last_updated": "2020-05-04",
        "certification_date": "2020-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carol Anne Jackson, BCBA
• Dashanette Jackson
• Eva Cardenas Jackson
• Halee Jackson
• Jadia Jackson
• Kiesha L Jackson
• Kimberly Jackson, HAIR LOSS SPECIALIST
• Martha Lene Jackson
• Matthew Jackson, LPA
• McKenna Jackson, MS, CCC/SLP

• Counselor in Plano, TX
• Providers in Plano, TX by specialty
• Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2020; 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.