Edward Jackson Jr., LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

001679 Issued in NY

Practice address

700 Parkside Ave Ste 200
Buffalo, NY 14216-2458

Phone

(716) 201-0522

NPI assigned

Oct 20, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Hiding Place Individual Family and Marriage Therapy PLLC

  • Marriage & Family Therapist
  • Tonawanda, NY
  • NPI 1467239814
  NPD Authorized official
• Christian Counseling Ministries of Western New York Inc

  • Multi-Specialty Clinic/Center
  • Clarence, NY
  • NPI 1033836762

  Marriage & Family Therapist

  NPD (past)
• Shine Medical PC

  • Psychiatry Physician
  • New York, NY
  • NPI 1427783950
  NPD (past)
• Shine Medical Providers PC

  • Psychiatry Physician
  • Philadelphia, PA
  • NPI 1538894050
  NPD (past)

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

{
    "created_epoch": "1603152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784678400000",
    "number": "1649879743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1868 NIAGARA FALLS BLVD STE 103",
            "city": "TONAWANDA",
            "state": "NY",
            "postal_code": "141506494",
            "telephone_number": "716-201-0522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 PARKSIDE AVE STE 200",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142162458",
            "telephone_number": "716-201-0522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "EDWARD",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-10-20",
        "last_updated": "2026-07-22",
        "certification_date": "2026-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NY",
            "license": "001679",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Jackson
• Christine Jackson
• Clifton Jackson
• Corrine R Jackson, LMT
• Desirae Jackson, CDA
• Evelyn Anita Jackson, RN
• Iesha Jackson
• Jasmine M Jackson, LPN
• Joanna Jackson
• Jordanei Rebecca Jackson

• Marriage & Family Therapist in Buffalo, NY
• Providers in Buffalo, NY by specialty
• Marriage & Family Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2026; 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.