Velma J. Jackson, CADC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

241831 Issued in KY

Practice address

413 E Dixie Ave Ste 106
Elizabethtown, KY 42701-1162

Phone

(270) 319-9899

NPI assigned

Apr 1, 2020

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

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

{
    "created_epoch": "1585699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585699200000",
    "number": "1891323010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "413 E DIXIE AVE STE 106",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427011162",
            "telephone_number": "270-319-9899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "413 E DIXIE AVE STE 106",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427011162",
            "telephone_number": "270-319-9899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "VELMA",
        "middle_name": "J.",
        "credential": "CADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-01",
        "last_updated": "2020-04-01",
        "certification_date": "2020-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "KY",
            "license": "241831",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• J. P. Interventions, Inc
• Calvin Jackson, LPA
• Kimberly L Jackson
• Richard Thomas Jackson, CSFA
• Thad Jackson, MD
• Jacob Schultz Rehabilitation Services
• Cynthia O Jacobi, LPCC
• Deloris M Jacobs, APRN
• Wendy Jacoby, TCM
• Amy Marie Jaggers

• All providers in Elizabethtown, KY
• Addiction (Substance Use Disorder) Counselor in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2020; 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.