Active NPI
Justice Jackson
- Behavior Technician
- Midlothian, VA
National Provider Identifier
1578273116
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-22-245110
- Practice address
- 2820 Waterford Lake Dr Ste 102
Midlothian, VA 23112-3994 - Phone
- (804) 562-6604
- Fax
- (757) 970-0277
- NPI assigned
- Dec 5, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | RBT-22-245110 | VA | Primary |
Addresses
Primary practice location
2820 Waterford Lake Dr Ste 102
Midlothian, VA 23112-3994
Mailing address
6800 Paragon PL Ste 200
Richmond, VA 23230-1652
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RBT-22-245110 | VA | MD | Behavior Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Insight Inc | Behavior Technician | Current | Accepting new patients |
Locations
2820 Waterford Lake Dr
Ste 102
Midlothian, VA 23112
Phone (804) 372-3473
6800 Paragon Pl
Ste 200
Richmond, VA 23230
Phone (757) 768-6914
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1670198400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1670198400000",
"number": "1578273116",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6800 PARAGON PL STE 200",
"city": "RICHMOND",
"state": "VA",
"postal_code": "232301652"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2820 WATERFORD LAKE DR STE 102",
"city": "MIDLOTHIAN",
"state": "VA",
"postal_code": "231123994",
"telephone_number": "804-562-6604",
"fax_number": "757-970-0277"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "JUSTICE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-12-05",
"last_updated": "2022-12-05",
"certification_date": "2022-12-04",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "VA",
"license": "RBT-22-245110",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Midlothian, VA
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- J Mark Oshea Inc
- Clayton Jackson
- Jordan Aaron Jackson, M.D.
- Kristen Marshelle Jackson
- Jacob Clark Psychotherapy Group
- Jade's Healing Grove
- Jame T Rickman IV DDS PC
- James River Dermatology PLLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.