Individual provider Active NPI

Robin Elaine Jackson

  • Professional Counselor
  • Milford, OH
National Provider Identifier
1821582776
Registry record updated Dec 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
C.2406666 Issued in OH
Practice address
25 Whitney Dr Ste 122
Milford, OH 45150-8400
Phone
(513) 941-4999
Fax
(513) 694-0168
NPI assigned
Jun 14, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 20, 2024

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X LCDCIII.162469 OH
Addiction (Substance Use Disorder) Counselor 101YA0400X LCDCII.161636 OH
Addiction (Substance Use Disorder) Counselor 101YA0400X CDCA.166828 OH
Addiction (Substance Use Disorder) Counselor 101YA0400X CDCA.162999 OH
Mental Health Counselor 101YM0800X C.2405498-TRNE OH
Professional Counselor 101YP2500X C.2406666 OH Primary

Addresses

Primary practice location

25 Whitney Dr Ste 122
Milford, OH 45150-8400

Mailing address

6460 Harrison Ave Ste 200
Cincinnati, OH 45247-7958
Phone (513) 941-4999

Other practice location 1

1130 Garbry Rd
Piqua, OH 45356-8217
Phone (513) 941-4999

Other practice location 2

1435 Cincinnati St
Dayton, OH 45417-4614
Phone (513) 941-4999

Other practice location 3

247 Cic Blvd
West Union, OH 45693-7512
Phone (513) 941-4999

Other practice location 4

1421 Parker Ct
Springfield, OH 45504-2855
Phone (513) 941-4999

Other practice location 5

1907 11th St
Portsmouth, OH 45662-4531
Phone (513) 941-4999

Other practice location 6

7075 Industrial Rd Ste A
Florence, KY 41042-3053
Phone (513) 941-4999

Other practice location 7

1718 Central Pkwy
Cincinnati, OH 45214-2355
Phone (513) 941-4999

Other practice location 8

6460 Harrison Ave Ste 200
Cincinnati, OH 45247-7958
Phone (513) 941-4999

Other practice location 9

160 N Breiel Blvd
Middletown, OH 45042-3806
Phone (513) 941-4999

Other practice location 10

680 Northland Blvd
Cincinnati, OH 45240-3248
Phone (513) 941-4999

Other practice location 11

100 Highview Blvd
Columbus, OH 43207-6023
Phone (513) 941-4999

Other identifiers 1

IdentifierTypeStateIssuer
0339385MedicaidOH

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

LicenseStateTypeSpecialty
CDCA.162999OHMDAddiction (Substance Use Disorder) Counselor
CDCA.166828OHMDAddiction (Substance Use Disorder) Counselor
LCDCII.161636OHMDAddiction (Substance Use Disorder) Counselor
LCDCIII.162469OHMDAddiction (Substance Use Disorder) Counselor
C.2405498-TRNEOHMDMental Health Counselor
C.2406666OHMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Sunrise Treatment Center, LLC Past Accepting new patients
Concord Psychiatry, LLC Addiction (Substance Use Disorder) Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1528934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734652800000",
    "number": "1821582776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6460 HARRISON AVE STE 200",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452477958",
            "telephone_number": "513-941-4999",
            "fax_number": "513-694-0168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 WHITNEY DR STE 122",
            "city": "MILFORD",
            "state": "OH",
            "postal_code": "451508400",
            "telephone_number": "513-941-4999",
            "fax_number": "513-694-0168"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1130 Garbry Rd",
            "address_purpose": "LOCATION",
            "city": "Piqua",
            "state": "OH",
            "postal_code": "453568217",
            "country_code": "US",
            "telephone_number": "513-941-4999",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1435 Cincinnati St",
            "address_purpose": "LOCATION",
            "city": "Dayton",
            "state": "OH",
            "postal_code": "454174614",
            "country_code": "US",
            "telephone_number": "513-941-4999",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "247 Cic Blvd",
            "address_purpose": "LOCATION",
            "city": "West Union",
            "state": "OH",
            "postal_code": "456937512",
            "country_code": "US",
            "telephone_number": "513-941-4999",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1421 Parker Ct",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "OH",
            "postal_code": "455042855",
            "country_code": "US",
            "telephone_number": "513-941-4999",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1907 11th St",
            "address_purpose": "LOCATION",
            "city": "Portsmouth",
            "state": "OH",
            "postal_code": "456624531",
            "country_code": "US",
            "telephone_number": "513-941-4999",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7075 Industrial Rd Ste A",
            "address_purpose": "LOCATION",
            "city": "Florence",
            "state": "KY",
            "postal_code": "410423053",
            "country_code": "US",
            "telephone_number": "513-941-4999",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1718 Central Pkwy",
            "address_purpose": "LOCATION",
            "city": "Cincinnati",
            "state": "OH",
            "postal_code": "452142355",
            "country_code": "US",
            "telephone_number": "513-941-4999",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6460 Harrison Ave Ste 200",
            "address_purpose": "LOCATION",
            "city": "Cincinnati",
            "state": "OH",
            "postal_code": "452477958",
            "country_code": "US",
            "telephone_number": "513-941-4999",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "160 N Breiel Blvd",
            "address_purpose": "LOCATION",
            "city": "Middletown",
            "state": "OH",
            "postal_code": "450423806",
            "country_code": "US",
            "telephone_number": "513-941-4999",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "680 Northland Blvd",
            "address_purpose": "LOCATION",
            "city": "Cincinnati",
            "state": "OH",
            "postal_code": "452403248",
            "country_code": "US",
            "telephone_number": "513-941-4999",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 Highview Blvd",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432076023",
            "country_code": "US",
            "telephone_number": "513-941-4999",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "ROBIN",
        "middle_name": "ELAINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-14",
        "last_updated": "2024-12-20",
        "certification_date": "2024-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "LCDCIII.162469",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "LCDCII.161636",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "CDCA.166828",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "CDCA.162999",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "C.2405498-TRNE",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "C.2406666",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0339385",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milford, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2024; 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.