Active NPI
James C Jackson, LPC
- Professional Counselor
- Charlottesville, VA
National Provider Identifier
1720121965
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 0701001993
- Practice address
- 800 Preston Ave
Charlottesville, VA 22903-4420 - Phone
- (434) 792-1800
- NPI assigned
- Feb 15, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 0701001993 | VA | Primary |
Addresses
Primary practice location
800 Preston Ave
Charlottesville, VA 22903-4420
Mailing address
71 Tanbark Plaza
Lovingston, VA 22949
Phone (434) 263-4889
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 004945018 | Medicaid | VA |
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 |
|---|---|---|---|
| 0701001993 | VA | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171497600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1291939200000",
"number": "1720121965",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "71 TANBARK PLAZA",
"city": "LOVINGSTON",
"state": "VA",
"postal_code": "22949",
"telephone_number": "434-263-4889"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 PRESTON AVE",
"city": "CHARLOTTESVILLE",
"state": "VA",
"postal_code": "229034420",
"telephone_number": "434-792-1800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "JAMES",
"middle_name": "C",
"name_prefix": "Mr.",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-15",
"last_updated": "2010-12-10",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "VA",
"license": "0701001993",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "004945018",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Charlottesville, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.