Active NPI
Nathaniel Jackson, L.P.C.
- Professional Counselor
- Dallas, TX
National Provider Identifier
1750546826
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 71884
- Practice address
- 16135 Preston Rd
Suite #201
Dallas, TX 75248-3599 - Phone
- (972) 841-6462
- NPI assigned
- Jul 28, 2008
- Sex
- Male
- Sole proprietor
- Yes
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 | 71884 | TX | Primary |
Addresses
Primary practice location
16135 Preston Rd
Suite #201
Dallas, TX 75248-3599
Mailing address
16135 Preston Rd
Suite #201
Dallas, TX 75248-3599
Phone (972) 841-6462
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Feb 7, 2024 through Feb 7, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 71884 | TX | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1217203200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1502755200000",
"number": "1750546826",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16135 PRESTON RD",
"address_2": "SUITE #201",
"city": "DALLAS",
"state": "TX",
"postal_code": "752483599",
"telephone_number": "972-841-6462"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16135 PRESTON RD",
"address_2": "SUITE #201",
"city": "DALLAS",
"state": "TX",
"postal_code": "752483599",
"telephone_number": "972-841-6462"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "NATHANIEL",
"credential": "L.P.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-07-28",
"last_updated": "2017-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "71884",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.