Alicia Jackson, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

6401011272 Issued in MI

Practice address

79 W Alexandrine
Detroit, MI 48201-2015

Phone

(313) 831-5535

Fax

(313) 831-2608

NPI assigned

Feb 4, 2013

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

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.

• Reclaiming Clarity Therapy and Consultation Services PLLC

  • Mental Health Counselor
  • Hazel Park, MI
  • NPI 1780400200
  NPD Authorized official
• Wentworth and Associates PC

  • Psychologist
  • Utica, MI
  • NPI 1306827191
  NPD

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

{
    "created_epoch": "1359936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485820800000",
    "number": "1689913147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "79 W ALEXANDRINE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012015",
            "telephone_number": "313-550-2502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "79 W ALEXANDRINE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012015",
            "telephone_number": "313-831-5535",
            "fax_number": "313-831-2608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "ALICIA",
        "name_prefix": "Ms.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-04",
        "last_updated": "2017-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401011272",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary L Jackson-Hammond, M.D.
• Karen Ann Jackson-Holzhauer, RD,FAND
• Dinika Jackson-Tarrant
• Julie Anne Jackson-Ward, RN
• Aisha Delane Jackson
• Alisha F. Jackson
• Altrosius J Jackson
• Anastasia Jackson
• Angelene Darque Jackson
• Anjel Jackson

• Professional Counselor in Detroit, MI
• Providers in Detroit, MI by specialty
• Professional Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2017; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.