Active NPI
Kashanta Murphy Jackson, LPC
- Professional Counselor
- Moorhead, MS
National Provider Identifier
1609544030
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 2308
- Practice address
- 13 Presidents Dr
Moorhead, MS 38761-6601 - Phone
- (662) 588-0486
- NPI assigned
- Aug 31, 2021
- Last updated
- Aug 31, 2021
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 2308 | MS | Primary |
Addresses
Primary practice location
13 Presidents Dr
Moorhead, MS 38761-6601
Mailing address
13 Presidents Dr
Moorhead, MS 38761-6601
Phone (662) 588-0486
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 |
|---|---|---|---|
| 2308 | MS | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1630368000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1630368000000",
"number": "1609544030",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13 PRESIDENTS DR",
"city": "MOORHEAD",
"state": "MS",
"postal_code": "387616601",
"telephone_number": "662-588-0486"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13 PRESIDENTS DR",
"city": "MOORHEAD",
"state": "MS",
"postal_code": "387616601",
"telephone_number": "662-588-0486"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "KASHANTA",
"middle_name": "MURPHY",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-08-31",
"last_updated": "2021-08-31",
"certification_date": "2021-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MS",
"license": "2308",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Moorhead, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.