Mallary Jackson, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

75010016559 Issued in MI

Practice address

18218 James Couzens Fwy
Detroit, MI 48235-2501

Phone

(313) 699-5301

NPI assigned

Dec 1, 2025

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Jupiter Wellness Co LLC

  • Health Service Clinic/Center
  • Detroit, MI
  • NPI 1659235224
  NPD Authorized official

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

{
    "created_epoch": "1764547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764547200000",
    "number": "1851253702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41470 E ARCHWOOD DR APT A134",
            "city": "VAN BUREN TOWNSHIP",
            "state": "MI",
            "postal_code": "481114501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18218 JAMES COUZENS FWY",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482352501",
            "telephone_number": "313-699-5301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "MALLARY",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-12-01",
        "last_updated": "2025-12-01",
        "certification_date": "2025-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "MI",
            "license": "75010016559",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lenora Jackson
• Lori Jackson
• Lynda Rochelle Jackson, MA
• Ma'Kayla Chree Jackson
• Maleeka Ali Jackson, LLMSW
• Margaret Elaine Jackson, LBSW
• Mariah Jackson
• Michael Jackson, LMSW
• Monique Jackson
• Myles Jackson

• Massage Therapist in Detroit, MI
• Providers in Detroit, MI by specialty
• Massage Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2025; 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.