Kimberly Dione Jackson, MS,LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC006188 Issued in GA

Practice address

233 Mitchell St SW Ste 510
Atlanta, GA 30303-3322

Phone

(678) 595-8060

Fax

(678) 595-8060

NPI assigned

Apr 14, 2011

Last updated

Apr 14, 2011By the provider in NPPES

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

Other names 1

• Ms. Kimberly Dione Jackson Professional name

Medicare fee-for-service enrollment

Enrolled in GA

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

Specialty

Mental Health Counselor

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ican Think Positive Counseling and Coaching ServicesGroup PAC ID 7214457860, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Ican Think Positive Counseling and Coaching Services

  • Community/Behavioral Health Agency
  • Stone Mountain, GA
  • NPI 1962824466
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1302739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302739200000",
    "number": "1538459227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "233 MITCHELL ST SW STE 510",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303033322",
            "telephone_number": "678-595-8060",
            "fax_number": "678-595-8060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "233 MITCHELL ST SW STE 510",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303033322",
            "telephone_number": "678-595-8060",
            "fax_number": "678-595-8060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "KIMBERLY",
        "middle_name": "DIONE",
        "name_prefix": "Ms.",
        "credential": "MS,LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-04-14",
        "last_updated": "2011-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC006188",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "JACKSON",
            "middle_name": "DIONE",
            "prefix": "MS.",
            "credential": "MS, LPC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Kathryn Horton Jackson, RPH
• Katie Jackson
• Keeara Jackson
• Kia Jackson, M.ED.
• Kimberly Jackson, R.D.N..
• Kira Jackson
• Kristy Lee Jackson, RN
• Ladeania Lilth Jackson, RN
• Lana Jean Jackson, P.A.
• Larette Denise Jackson, CRNA

• Professional Counselor in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2011; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.