Active NPI
Robert Lawrence Jackson Jr.
- Mental Health Counselor
- Tulsa, OK
National Provider Identifier
1790004901
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 2448 E 81St St
Suite 4824 / Citiplextowers
Tulsa, OK 74137-4250 - Phone
- (918) 486-9996
- NPI assigned
- May 27, 2010
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
2448 E 81St St
Suite 4824 / Citiplextowers
Tulsa, OK 74137-4250
Mailing address
2413 Larkhaven St
Norman, OK 73071-4326
Phone (405) 216-5608
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1274918400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1318550400000",
"number": "1790004901",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2413 LARKHAVEN ST",
"city": "NORMAN",
"state": "OK",
"postal_code": "730714326",
"telephone_number": "405-216-5608"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2448 E 81ST ST",
"address_2": "SUITE 4824 / CITIPLEXTOWERS",
"city": "TULSA",
"state": "OK",
"postal_code": "741374250",
"telephone_number": "918-486-9996"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "ROBERT",
"middle_name": "LAWRENCE",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-05-27",
"last_updated": "2011-10-14",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tulsa, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.