Jackson Counseling Agency

Primary specialty

Social WorkerTaxonomy code 104100000X

Legal business name

JACKSON COUNSELING AGENCY

Practice address

1900 W Stadium Blvd
6&7
Ann Arbor, MI 48103-7008

Phone

(734) 913-9225

NPI assigned

Apr 2, 2008

Organization subpart

No

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

Authorized official

Name

Richard Allen Jackson Sr., LMSW LCSW

Title

Director and Owner

Phone

(734) 913-9225

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1207094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207094400000",
    "number": "1790958460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 W STADIUM BLVD",
            "address_2": "6&7",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481037008",
            "telephone_number": "734-913-9225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 W STADIUM BLVD",
            "address_2": "6&7",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481037008",
            "telephone_number": "734-913-9225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON COUNSELING AGENCY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-02",
        "last_updated": "2008-04-02",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "DIRECTOR AND OWNER",
        "authorized_official_telephone_number": "734-913-9225",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "LMSW LCSW"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thaddeus Jabzanka
• Mary Ellen Jachec, M.D.
• Cynthia Ann Jachym, RN
• Jamie George Jackish, M.D.
• Jackson Community Ambulance Inc.
• Brianna Jackson
• Hope Tiffany Jackson, M.D.
• Jasmyne Amanda Jackson, MD
• Jeffrey Frank Jackson, CRNA
• Jillian Brianne Jackson

• Social Worker in Ann Arbor, MI
• Providers in Ann Arbor, MI by specialty
• Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2008; 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.