Active NPI
Casey Eden Jackson, PLPC
- Professional Counselor
- Kansas City, MO
National Provider Identifier
1811403660
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 2017009204
- Practice address
- 10918 Elm Ave Ste 102
Kansas City, MO 64134-2284 - Phone
- (816) 767-4230
- NPI assigned
- Dec 15, 2017
- Sex
- Male
- 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 | 2017009204 | MO | Primary |
Addresses
Primary practice location
10918 Elm Ave Ste 102
Kansas City, MO 64134-2284
Mailing address
10918 Elm Ave
Kansas City, MO 64134-4108
Phone (816) 767-4230
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 |
|---|---|---|---|
| 2017009204 | MO | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1513296000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1513296000000",
"number": "1811403660",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10918 ELM AVE",
"city": "KANSAS CITY",
"state": "MO",
"postal_code": "641344108",
"telephone_number": "816-767-4230"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10918 ELM AVE STE 102",
"city": "KANSAS CITY",
"state": "MO",
"postal_code": "641342284",
"telephone_number": "816-767-4230"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "CASEY",
"middle_name": "EDEN",
"name_prefix": "Mr.",
"credential": "PLPC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-12-15",
"last_updated": "2017-12-15",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MO",
"license": "2017009204",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kansas City, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 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.