Individual provider Active NPI

Amari Jackson, LCPC

  • Counselor
  • Chicago, IL
National Provider Identifier
1669829180
Registry record updated Jun 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
180011861 Issued in IL
Practice address
332 S Michigan Ave Ste 400C
Chicago, IL 60604-4434
Phone
(312) 498-1559
NPI assigned
May 16, 2016
Last updated
Jun 4, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 4, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 180011861 IL Primary

Addresses

Primary practice location

332 S Michigan Ave Ste 400C
Chicago, IL 60604-4434

Mailing address

332 S Michigan Ave Ste 400C
Chicago, IL 60604-4434
Phone (312) 577-7258

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260603004123 IL Practitioner - Mental Health Counselor 0042781767 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

332 S Michigan Ave
Suite 400C
Chicago, IL 60604-4434
Phone (312) 577-7258

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
180011861ILMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Growing Boundlessly LLC CurrentSince Apr 20, 2026 Accepting new patients

Locations

1136 S Delano Ct W
Ste B201
Chicago, IL 60605
Phone (312) 248-0230

332 S Michigan Ave
Ste 121
Chicago, IL 60604
Phone (312) 278-3885

332 S Michigan Ave
Ste 400C
Chicago, IL 60604
Phone (312) 498-1559

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1463356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780531200000",
    "number": "1669829180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "332 S MICHIGAN AVE STE 400C",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606044434",
            "telephone_number": "312-577-7258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "332 S MICHIGAN AVE STE 400C",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606044434",
            "telephone_number": "312-498-1559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "AMARI",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-16",
        "last_updated": "2026-06-04",
        "certification_date": "2026-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "IL",
            "license": "180011861",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.