Active NPI
Terri Jackson
- Mental Health Counselor
- Las Vegas, NV
National Provider Identifier
1699075853
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- CI0335
- Practice address
- 1104 Allure Dr
Las Vegas, NV 89128-2095 - Phone
- (702) 561-2725
- NPI assigned
- Oct 21, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rehabilitation Practitioner | 225400000X | |||
| Mental Health Counselor | 101YM0800X | CI0335 | NV | Primary |
Addresses
Primary practice location
1104 Allure Dr
Las Vegas, NV 89128-2095
Mailing address
PO Box 753394
Las Vegas, NV 89136-3394
Phone (702) 100-0000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CI0335 | NV | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| TJ Mental Health Services LLC | Past | Accepting new patients | |
| Compassionate Hearts Personal Care LLC | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- In Home Supportive Care Agency
- Las Vegas, NV
- NPI 1366951204
-
- Community/Behavioral Health Agency
- Las Vegas, NV
- NPI 1457633505
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1287619200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1642723200000",
"number": "1699075853",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 753394",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891363394",
"telephone_number": "702-100-0000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1104 ALLURE DR",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891282095",
"telephone_number": "702-561-2725"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "TERRI",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-10-21",
"last_updated": "2022-01-21",
"certification_date": "2022-01-21",
"status": "A"
},
"taxonomies": [
{
"code": "225400000X",
"taxonomy_group": "",
"desc": "Rehabilitation Practitioner",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NV",
"license": "CI0335",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Las Vegas, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.