Linda Teresa Jackosn

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

675 N Matthews Rd
Lake City, SC 29560-7027

Phone

(843) 394-7600

NPI assigned

Apr 25, 2013

Last updated

Apr 25, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1366848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366848000000",
    "number": "1770927386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "675 N MATTHEWS RD",
            "city": "LAKE CITY",
            "state": "SC",
            "postal_code": "295607027",
            "telephone_number": "843-394-7600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 N MATTHEWS RD",
            "city": "LAKE CITY",
            "state": "SC",
            "postal_code": "295607027",
            "telephone_number": "843-394-7600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKOSN",
        "first_name": "LINDA",
        "middle_name": "TERESA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-25",
        "last_updated": "2013-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "376421",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "3337",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hopehealth Inc (HopeHealth J. Paul Truluck School-based Health Center)
• Hopehealth, Inc
• Hopehealth, Inc (HopeHealth Dental Lake City)
• T'Auna Hudson
• Ih3 Physcial Therapy (CPM Physical Therapy)
• David Jackson Jr., PTA
• Paul Wells James, DNP
• Kirby Rebekah Jeffords
• Carlon Darneil Jenkins, NP
• Sheriko Jernigan

• Mental Health Counselor in Lake City, SC
• Providers in Lake City, 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 Apr 25, 2013; 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.