Charles Jerome Jackson, LPC, LMFT

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

P0803027 Issued in AR

Practice address

2707 Browns LN
Jonesboro, AR 72401-7213

Phone

(870) 972-4000

NPI assigned

Apr 3, 2007

Last updated

Mar 5, 2026By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AR

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, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Arisa Health IncGroup PAC ID 2264853829, 65 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Arisa Health, Inc.

  • Community/Behavioral Health Agency
  • Springdale, AR
  • NPI 1437750411

  Professional

  Medicare reassignment Care Compare group NPD
• Professional Counseling Associates Inc.

  • Community/Behavioral Health Agency
  • North Little Rock, AR
  • NPI 1437164977
  Medicare reassignment NPD
• Arisa Health, Inc.

  • Community/Behavioral Health Agency
  • Jonesboro, AR
  • NPI 1306532767
  NPD
• Retrospect Counseling, PLLC

  dba Douglas Strickland

  • Professional Counselor
  • Paragould, AR
  • NPI 1831777234
  NPD (past)

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772668800000",
    "number": "1700907920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2707 BROWNS LN",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724017213",
            "telephone_number": "870-972-4939",
            "fax_number": "870-972-4911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2707 BROWNS LN",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724017213",
            "telephone_number": "870-972-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4354 Stockton Dr",
            "address_purpose": "LOCATION",
            "city": "North Little Rock",
            "state": "AR",
            "postal_code": "721172917",
            "country_code": "US",
            "telephone_number": "501-955-7600",
            "fax_number": "501-955-7612",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "902 W Court St",
            "address_2": "Suite R",
            "address_purpose": "LOCATION",
            "city": "Paragould",
            "state": "AR",
            "postal_code": "724505921",
            "country_code": "US",
            "telephone_number": "870-215-0766",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "CHARLES",
        "middle_name": "JEROME",
        "name_prefix": "Mr.",
        "credential": "LPC, LMFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-03",
        "last_updated": "2026-03-05",
        "certification_date": "2026-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AR",
            "license": "P0803027",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "AR",
            "license": "M00806008",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anastasia Jackson, MCD, CCC-SLP
• Ashlee Erin Jackson
• Ashley M Jackson
• Azlyn Jackson, QBHP
• Blake Jackson
• Fraddia Jackson
• Hannah Lee Jackson
• Jonathan Allman Jackson
• Kristin Jackson, BCBA
• Lakisha Jackson

• Professional Counselor in Jonesboro, AR
• Providers in Jonesboro, AR by specialty
• Professional Counselor in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2026; 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.