Heyward Jackson Jr., LCADCI

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Practice address

3651 Lindell Rd
Las Vegas, NV 89103-1254

Phone

(702) 544-0355

NPI assigned

Jan 19, 2012

Sex

Male

Sole proprietor

Yes

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

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 and National Provider Directory roles.

• Crest Healthcare Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Las Vegas, NV
  • NPI 1306451711
  NPD Authorized official
• Crest Healthcare Inc.

  • Community/Behavioral Health Agency
  • Las Vegas, NV
  • NPI 1033555958
  NPD
• United Family Community Services

  • Cognitive & Behavioral Psychologist
  • North Las Vegas, NV
  • NPI 1104121292
  NPD (past)

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

{
    "created_epoch": "1326931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677024000000",
    "number": "1598036709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3651 LINDELL RD # D748",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891031254",
            "telephone_number": "702-544-0355",
            "fax_number": "866-499-2117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3651 LINDELL RD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891031254",
            "telephone_number": "702-544-0355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "HEYWARD",
        "name_suffix": "Jr.",
        "credential": "LCADCI",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-01-19",
        "last_updated": "2023-02-22",
        "certification_date": "2023-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225C00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gloria J. Jackson
• Grey'Sha Jackson
• Gwendolen Jackson
• Gwendolyn Michelle Jackson
• Harold Jackson
• Ingrid Jackson, RBT, CHW, C.HT.
• Inika Louzina Jackson
• Iquanisha Jackson
• Iris Jackson
• Jaclyn Jackson

• Behavior Analyst in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Behavior Analyst in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2023; 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.