NPIMap

Organization Active NPI

Jackson Healing Clinic LLC

  • Mental Health Counselor
  • Jackson, MI
National Provider Identifier
1629677893
Registry record updated Jan 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
JACKSON HEALING CLINIC LLC
Practice address
720 W Franklin St
Jackson, MI 49201-1674
Phone
(517) 581-4710
Fax
(517) 905-5906
NPI assigned
Oct 20, 2020
Last updated
Jan 31, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2025

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

Authorized official

Name
Heather Stiltner, MA, LPC, NCC, CTP-CNPI 1932594496
Title
Owner, Chief Clinical Director
Phone
(734) 726-4038

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

720 W Franklin St
Jackson, MI 49201-1674

Mailing address

PO Box 365
Jackson, MI 49204-0365
Phone (517) 581-4710

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210107000916 MI Part B Supplier - Clinic/Group Practice 0840603031 Receives reassigned benefits from 9 practitioners
Practice locations: Jackson, MI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 25

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1603152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738281600000",
    "number": "1629677893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 365",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492040365",
            "telephone_number": "517-581-4710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 W FRANKLIN ST",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011674",
            "telephone_number": "517-581-4710",
            "fax_number": "517-905-5906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON HEALING CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-20",
        "last_updated": "2025-01-31",
        "certification_date": "2025-01-31",
        "status": "A",
        "authorized_official_last_name": "STILTNER",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_title_or_position": "OWNER, CHIEF CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "734-726-4038",
        "authorized_official_credential": "MA, LPC, NCC, CTP-C"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.