Elaine White Jackson, LPCC,IIMFT

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

E0001726 Issued in OH

Practice address

14843 W Sprague Rd
Suite a
Strongsville, OH 44136-1754

Phone

(440) 234-9955

Fax

(440) 234-5994

NPI assigned

Jan 10, 2007

Last updated

Jul 8, 2007By the provider in NPPES

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 OH

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, 1989

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

Strongsville Psychological Services, Inc.Group PAC ID 5193740801, 10 clinicians

Practice addresses (Care Compare)

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

• Strongsville Psychological Services, Inc.

  • Mental Health Counselor
  • Middleburg Heights, OH
  • NPI 1942347661
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1548310048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14843 W SPRAGUE RD",
            "address_2": "SUITE A",
            "city": "STRONGSVILLE",
            "state": "OH",
            "postal_code": "441361754",
            "telephone_number": "440-234-9955",
            "fax_number": "440-234-5994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14843 W SPRAGUE RD",
            "address_2": "SUITE A",
            "city": "STRONGSVILLE",
            "state": "OH",
            "postal_code": "441361754",
            "telephone_number": "440-234-9955",
            "fax_number": "440-234-5994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "ELAINE",
        "middle_name": "WHITE",
        "credential": "LPCC,IIMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "E0001726",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stacey Ilko - Hancock, PSY.D
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• Danielle Beth Israeli, LSW
• Brigid Jackson
• Mary Catherine - Jacob, RNC, PC
• Beth T. Jacobs, L.I.S.W.
• Marci Jacobs
• Carrie Ann Jancar, MSSA, LISW
• Chelsea Jancewicz

• Mental Health Counselor in Strongsville, OH
• Providers in Strongsville, OH by specialty
• Mental Health Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.