Skylette V Jackson, LCPC (MD), LPC (VA)

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LC17807 Issued in MD

Practice address

12302 Somerset Ave Ste D
Princess Anne, MD 21853-3099

Phone

(443) 614-0829

NPI assigned

Apr 25, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Specialty

Mental Health Counselor

Education

Other, 2014

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1524614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776988800000",
    "number": "1639667611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12302 SOMERSET AVE",
            "city": "PRINCESS ANNE",
            "state": "MD",
            "postal_code": "218533099",
            "telephone_number": "443-614-0829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12302 SOMERSET AVE STE D",
            "city": "PRINCESS ANNE",
            "state": "MD",
            "postal_code": "218533099",
            "telephone_number": "443-614-0829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "SKYLETTE",
        "middle_name": "V",
        "credential": "LCPC (MD), LPC (VA)",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-25",
        "last_updated": "2026-04-24",
        "certification_date": "2026-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VA",
            "license": "0701015474",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": "LC17807",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "DE",
            "license": "1718",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bryant Julian Howard, LCSW-C
• Brett Michael Hughes
• Kristen Lea Hyland, DDS
• Phoebe Iloanya
• Jackson Patient Care Services LLC
• Sara James
• Roland Leon Jennings, LCSW-C
• Latoya Shenelle Johnson
• Lowa Gwen Johnson, LCPC
• Trent Johnson, DMD

• Mental Health Counselor in Princess Anne, MD
• Providers in Princess Anne, MD by specialty
• Mental Health Counselor in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.