Shantius Jackson, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Practice address

2400 Queens Chapel Rd Apt 402
Hyattsville, MD 20782-3637

Phone

(305) 345-5401

NPI assigned

Jun 23, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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": "1498176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1498176000000",
    "number": "1780104455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 QUEENS CHAPEL RD APT 402",
            "city": "HYATTSVILLE",
            "state": "MD",
            "postal_code": "207823637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 QUEENS CHAPEL RD APT 402",
            "city": "HYATTSVILLE",
            "state": "MD",
            "postal_code": "207823637",
            "telephone_number": "305-345-5401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "SHANTIUS",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-23",
        "last_updated": "2017-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bernardine C Iwuchukwu
• J Richard Lilly MD Shaaron R Towns MD and Associates PC
• Isihaka Jongo Jabiri
• Brandon Jackson-Mills, LMSW; LGSW
• Janice Jackson, LGSW
• Brandon Michael Jacobs, MD
• Colin Jacobson
• Byron Jaffe
• Olayinka K Jaiyesimi
• Evita G James, M.D., F.A.C.O.G.

• Professional Counselor in Hyattsville, MD
• Providers in Hyattsville, MD by specialty
• Professional Counselor in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2017; 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.