Monica Hicks Jackson

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

6451022433 Issued in MI

Practice address

411 W Lake Lansing Rd Ste C125
East Lansing, MI 48823-8485

Phone

(517) 574-4192

NPI assigned

Jul 24, 2024

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1721779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721779200000",
    "number": "1568290237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 W LAKE LANSING RD STE C125",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488238485",
            "telephone_number": "517-574-4192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 W LAKE LANSING RD STE C125",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488238485",
            "telephone_number": "517-574-4192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "MONICA",
        "middle_name": "HICKS",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-24",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YS0200X",
            "taxonomy_group": "",
            "desc": "Counselor, School",
            "state": "MI",
            "license": "SC0000001114637",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6451022433",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keith Wesley Ivens, M.D.
• Joseph Jacher, MS
• Anne Colleen Jack, LMSW
• Alexia Dominique Jackson, LAT, ATC
• Justice Jackson
• Jacob Myers, DDS, PLLC
• Kevin Jacobs, O.D.
• David Jager, ATC. LAT
• Meera Jain
• Connor James

• Mental Health Counselor in East Lansing, MI
• Providers in East Lansing, MI by specialty
• Mental Health Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 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.