Allison Charee Jackson, LPCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

104618 Issued in KY

Practice address

1448 Diederich Blvd
Russell, KY 41169-1719

Phone

(606) 834-0020

Fax

(606) 834-0049

NPI assigned

Mar 11, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KY

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

Specialty

Mental Health Counselor

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Extended Care Specialists, IncGroup PAC ID 2466407713, 295 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Extended Care Specialists, Inc

  • Adult Medicine Physician
  • Merrillville, IN
  • NPI 1134146079

  KY

  Medicare reassignment Care Compare group NPD
• Lighthouse Professional Counseling Services, PLLC

  • Professional Counselor
  • Ashland, KY
  • NPI 1003218546

  KY, Professional

  Medicare reassignment NPD

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

{
    "created_epoch": "1552262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554768000000",
    "number": "1669930517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1448 DIEDERICH BLVD",
            "city": "RUSSELL",
            "state": "KY",
            "postal_code": "411691719",
            "telephone_number": "606-834-0020",
            "fax_number": "606-834-0049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1448 DIEDERICH BLVD",
            "city": "RUSSELL",
            "state": "KY",
            "postal_code": "411691719",
            "telephone_number": "606-834-0020",
            "fax_number": "606-834-0049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "ALLISON",
        "middle_name": "CHAREE",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-11",
        "last_updated": "2019-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "KY",
            "license": "104618",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100587020",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mark E Hilburn, ATC
• Lincoln Foster Howard, DC
• Jennifer Baronis Hughes, D.M.D
• Inspire Therapy Services, LLC
• Interhope Christian Counseling PLLC
• Courtney Joyce, LPCA
• Melissa Gayle King, MA-CCC/SLP
• Lana J Davenport MD PLC
• Angela Dawn Lewis, DO
• Susan M. Lichtenberger, M.D.

• All providers in Russell, KY
• Professional Counselor in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2019; 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.