Amanda Jackson

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

CDCA194264 Issued in OH

Practice address

815 W Broad St Ste 200
Columbus, OH 43222-1465

Phone

(614) 717-0822

NPI assigned

Sep 21, 2021

Sex

Female

Sole proprietor

Yes

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)

Not enrolled

State licenses

Practice roles

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.

• Diamonds in Rough Mentoring Program

  • Peer Specialist
  • Columbus, OH
  • NPI 1821796087
  NPD Authorized official
• Center of Vocational Alternatives for Mental Health, Inc.

  • Public Health or Welfare Agency
  • Columbus, OH
  • NPI 1275589947
  NPD (past)
• Southeast, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Columbus, OH
  • NPI 1932169497
  NPD (past)

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

{
    "created_epoch": "1632182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768176000000",
    "number": "1649941576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3180 DRAKE AVE",
            "city": "GROVEPORT",
            "state": "OH",
            "postal_code": "431259006",
            "telephone_number": "614-625-4266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 W BROAD ST STE 200",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432221465",
            "telephone_number": "614-717-0822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "AMANDA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-21",
        "last_updated": "2026-01-12",
        "certification_date": "2026-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "CDCA194264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tammie Cherrelle Jackson-Malone, QBHS
• Achaundae Jackson
• Aleasha Dashawynna Jackson
• Alissa Nicole Jackson, LISW-S
• Alvin Glen Jackson, LPC
• Amber Nicole Jameka Jackson
• Angela Jackson
• Angelina C Jackson
• Angelique Jackson, RN
• Angenette McCoy Jackson, RN

• Addiction (Substance Use Disorder) Counselor in Columbus, OH
• Providers in Columbus, OH by specialty
• Addiction (Substance Use Disorder) Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 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.