Melissa Rena Jackson, MHR, LPC

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

11541 Village Ave
Midwest City, OK 73130-8207

Phone

(405) 201-3646

NPI assigned

Dec 29, 2011

Sex

Female

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

Enrolled in OK

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

Medicare enrollment (NPD)

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.

• Oklahoma Mental Health Council

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Oklahoma City, OK
  • NPI 1275574907
  Medicare reassignment NPD
• Oklahoma Mental Health Council

  • Community/Behavioral Health Agency
  • Hobart, OK
  • NPI 1801219340
  NPD

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

{
    "created_epoch": "1325116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377734400000",
    "number": "1609145184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11541 VILLAGE AVE",
            "city": "MIDWEST CITY",
            "state": "OK",
            "postal_code": "731308207",
            "telephone_number": "405-201-3646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11541 VILLAGE AVE",
            "city": "MIDWEST CITY",
            "state": "OK",
            "postal_code": "731308207",
            "telephone_number": "405-201-3646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "MELISSA",
        "middle_name": "RENA",
        "name_prefix": "Ms.",
        "credential": "MHR, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-12-29",
        "last_updated": "2013-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OK",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jack E. Hopkins, O.D., Inc.
• Cheryl Lynn Jackson
• Collin Dale Jackson
• Derisha Jackson
• Kaira Jackson
• Shakera Jackson
• Shamia Jackson
• Ter-Ree L. Jackson
• Sheryl M Jacob
• James E Mays MD Inc

• Counselor in Midwest City, OK
• Providers in Midwest City, OK by specialty
• Counselor in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2013; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.