Candace Smith Jackson, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

406 Parker Ivey Dr
Greenville, SC 29607-6513

Phone

(864) 395-6786

Fax

(864) 900-0452

NPI assigned

Apr 28, 2011

Last updated

Dec 21, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Ms. Candace Deanna Smith Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Let the Sunshine in LLC

  dba Candace Smith Jackson

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Greenville, SC
  • NPI 1962114827
  NPD Authorized official
• South Carolina Dept of Mental Health Accounting Office

  dba Midlands Crisis Stabilization Center

  • Community/Behavioral Health Agency
  • Columbia, SC
  • NPI 1083421994
  NPD (past)
• South Carolina Dept of Mental Health Accounting Office

  dba Piedmont Center for Mental Health Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Simpsonville, SC
  • NPI 1306949482
  NPD (past)

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

{
    "created_epoch": "1303948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671580800000",
    "number": "1760773527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "406 PARKER IVEY DR",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296076513",
            "telephone_number": "864-395-6786",
            "fax_number": "864-900-0452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 PARKER IVEY DR",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296076513",
            "telephone_number": "864-395-6786",
            "fax_number": "864-900-0452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "CANDACE",
        "middle_name": "SMITH",
        "name_prefix": "Ms.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-04-28",
        "last_updated": "2022-12-21",
        "certification_date": "2022-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "SC",
            "license": "5725",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CANDACE",
            "last_name": "SMITH",
            "middle_name": "DEANNA",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Antonia Elizabeth Jacks, PT, DPT
• Allison Giddings Jackson, M.D.
• Alyssa Jackson
• Amy Sue Jackson, RPH
• Ande M Jackson, MS,CNC
• Carolyn E Jackson
• Charles Anthony Jackson
• Clintonia Jackson, M.D.
• Cornelia Yvette Jackson
• Denise L. Jackson, P.A.

• Mental Health Counselor in Greenville, SC
• Providers in Greenville, SC by specialty
• Mental Health Counselor in South Carolina

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

Verify at the official NPI Registry.