Vallery Jackson, MA, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

178.017955 Issued in IL

Practice address

1325 Remington Rd Ste O
Schaumburg, IL 60173-4815

Phone

(224) 633-9323

NPI assigned

Dec 4, 2020

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

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.

• Clay Therapeutic Services

  • Professional Counselor
  • Schaumburg, IL
  • NPI 1982148334
  NPD

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

{
    "created_epoch": "1607040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722297600000",
    "number": "1548866684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1325 REMINGTON RD",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601734834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 REMINGTON RD STE O",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601734815",
            "telephone_number": "224-633-9323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "VALLERY",
        "credential": "MA, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-04",
        "last_updated": "2024-07-30",
        "certification_date": "2024-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178.017955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nour Issa, DMD
• Renata Izewski, LAC BS NUTR
• Richard Slavomir Izewski, MD
• Le'Ana Jackson
• Treneice Jackson
• Jaclyn a. Slovick DDS LTD (Dr Jackie's Family Dental)
• Silu Jacob
• Susan D Jacobs, LCSW
• Gary K Jacobson, D.D.S.
• Jade Care at Home Inc

• Professional Counselor in Schaumburg, IL
• Providers in Schaumburg, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.