Active NPI
Julie R Jackson, M.ED., NCC, LPCA
- Professional Counselor
- Charlotte, NC
National Provider Identifier
1871040469
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- A12451
- Practice address
- 7810 Prineville-Mathews Road
Charlotte, NC 28226 - Phone
- (704) 877-8663
- NPI assigned
- Sep 1, 2016
- Sex
- Female
- Sole proprietor
- Yes
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 | A12451 | NC | Primary |
Addresses
Primary practice location
7810 Prineville-Mathews Road
Charlotte, NC 28226
Mailing address
2294 Hanover CT
Fort Mill, SC 29707-6486
Phone (704) 877-8663
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Dec 9, 2024 through Dec 9, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Education
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A12451 | NC | MD | Professional Counselor |
| 7179 | SC | MD | Obstetrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1472688000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1491955200000",
"number": "1871040469",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2294 HANOVER CT",
"city": "FORT MILL",
"state": "SC",
"postal_code": "297076486",
"telephone_number": "704-877-8663"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7810 PRINEVILLE-MATHEWS ROAD",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "28226",
"telephone_number": "704-877-8663"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "JULIE",
"middle_name": "R",
"name_prefix": "Ms.",
"credential": "M.ED., NCC, LPCA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-09-01",
"last_updated": "2017-04-12",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NC",
"license": "A12451",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.