Active NPI
Clarisse L Jackson
- Professional Counselor
- Aurora, CO
National Provider Identifier
1801059282
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 178.006033
- Practice address
- 6240 S Main St
Suite 265
Aurora, CO 80016-5376 - Phone
- (720) 274-5296
- Fax
- (720) 274-5267
- NPI assigned
- Jul 7, 2008
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 178.006033 | IL | Primary |
Addresses
Primary practice location
6240 S Main St
Suite 265
Aurora, CO 80016-5376
Mailing address
6240 S Main St
Suite 265
Aurora, CO 80016-5376
Phone (720) 274-5296
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 178.006033 | IL | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Life Counseling, P.C. | Professional | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Professional Counselor
- Aurora, CO
- NPI 1053508986
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1215388800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1262908800000",
"number": "1801059282",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6240 S MAIN ST",
"address_2": "SUITE 265",
"city": "AURORA",
"state": "CO",
"postal_code": "800165376",
"telephone_number": "720-274-5296",
"fax_number": "720-274-5267"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6240 S MAIN ST",
"address_2": "SUITE 265",
"city": "AURORA",
"state": "CO",
"postal_code": "800165376",
"telephone_number": "720-274-5296",
"fax_number": "720-274-5267"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "CLARISSE",
"middle_name": "L",
"name_prefix": "Ms.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-07-07",
"last_updated": "2010-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "IL",
"license": "178.006033",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Aurora, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.