Jackson Professional Services

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

MFTMFT00220805 Issued in KY

Legal business name

JACKSON PROFESSIONAL SERVICES

Practice address

1827 Eastern Pkwy
Louisville, KY 40204-1416

Phone

(859) 475-3482

NPI assigned

Mar 25, 2016

Organization subpart

No

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

Authorized official

Name

Kristyn Jackson, M.S.

Title

LMFT

Phone

(859) 475-3482

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1458864000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458864000000",
    "number": "1700248028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1827 EASTERN PKWY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402041416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1827 EASTERN PKWY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402041416",
            "telephone_number": "859-475-3482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON PROFESSIONAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-25",
        "last_updated": "2016-03-25",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "KRISTYN",
        "authorized_official_title_or_position": "LMFT",
        "authorized_official_telephone_number": "859-475-3482",
        "authorized_official_credential": "M.S."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "KY",
            "license": "MFTMFT00220805",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Jaber, PHARMD
• Leslie Corinne Jablon
• Megan Elizabeth Jablonski, PH.D.
• Laura K Jacks, M.D.
• Jackson Dental Health Specialists, PLLC
• Latesia Jackson-Morris, MSSW/MA
• Sonia L Jackson-Suggs
• Alan David Jackson, M.D.
• Alicia Jackson, RT
• Alisia Jackson, APRN

• Community/Behavioral Health Agency in Louisville, KY
• Providers in Louisville, KY by specialty
• Community/Behavioral Health Agency in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2016; 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.