Individual provider Active NPI

Lanette Jackson, LPC

  • Professional Counselor
  • Colorado Springs, CO
National Provider Identifier
1821688789
Registry record updated Aug 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC.0020748 Issued in CO
Practice address
3472 Research Pkwy Ste 100
Colorado Springs, CO 80920-1066
Phone
(719) 358-2410
Fax
(719) 715-6442
NPI assigned
Jan 24, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 19, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LPC.0020748 CO Primary

Addresses

Primary practice location

3472 Research Pkwy Ste 100
Colorado Springs, CO 80920-1066

Mailing address

3472 Research Pkwy Ste 100
Colorado Springs, CO 80920-1066
Phone (719) 358-2410

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250205001868 CO Practitioner - Mental Health Counselor 8729494414 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LPC.0020748COMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Matthews-Vu Medical Group, P.C. CurrentSince Dec 5, 2024 Accepting new patients
Matthews-Vu Medical Group, P.C. Current Accepting new patients
Matthews-Vu Medical Group, P.C. CurrentSince Dec 5, 2024 Accepting new patients

Locations

4190 E Woodmen Rd
Colorado Springs, CO 80920
Phone (719) 722-2542

4190 E Woodmen Rd
Ste 100
Colorado Springs, CO 80920
Phone (630) 364-4851

104 Pro Rodeo Dr
Ste 100
Colorado Springs, CO 80919
Phone (719) 522-0707

Organizations & group practices 3

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": "1611446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787097600000",
    "number": "1821688789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3472 RESEARCH PKWY STE 100",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809201066",
            "telephone_number": "719-358-2410",
            "fax_number": "719-715-6442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3472 RESEARCH PKWY STE 100",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809201066",
            "telephone_number": "719-358-2410",
            "fax_number": "719-715-6442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "LANETTE",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-24",
        "last_updated": "2026-08-19",
        "certification_date": "2026-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CO",
            "license": "LPC.0020748",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.