Jennifer Davis Jackson, LCAS

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

429 Billingsley Rd
Charlotte, NC 28211

Phone

(704) 445-6900

NPI assigned

Oct 30, 2007

Last updated

Jul 21, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jennifer Ann Davis Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1193702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1871772517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "429 BILLINGSLEY RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282111007",
            "telephone_number": "704-445-6900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "429 BILLINGSLEY RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28211",
            "telephone_number": "704-445-6900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "515 Clanton Rd",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282171309",
            "country_code": "US",
            "telephone_number": "704-332-9001 x2287",
            "fax_number": "704-295-4251",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 Billingsley Rd",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282111002",
            "country_code": "US",
            "telephone_number": "704-376-7447",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "JENNIFER",
        "middle_name": "DAVIS",
        "credential": "LCAS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-30",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "DAVIS",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Henretta Collin Jackson, DMIN
• Jacqueline Landa Jackson, M.ED., BCBA
• Jacquelyn Chrisana Jackson, MD
• Jalisa Jackson
• Jasmine Dearis Jackson, PHARMD
• Jessica Lynn Jackson, FNP
• John Mark Jackson, LPC
• Julia Dawn Jackson, MED, ATC, LAT
• Julie R Jackson, M.ED., NCC, LPCA
• Kasey Leigh Jackson, PHARMD

• Addiction (Substance Use Disorder) Counselor in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Addiction (Substance Use Disorder) Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.