Diana Sue Jackson, LMHC, CADC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

079713 Issued in IA

Practice address

1744 2ND Ave SE
Cedar Rapids, IA 52403-2306

Phone

(319) 366-4673

NPI assigned

Aug 25, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IA

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

Specialty

Mental Health Counselor

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

House of HopeGroup PAC ID 7911444070, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• House of Hope

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Cedar Rapids, IA
  • NPI 1326564527
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1472083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556668800000",
    "number": "1902352412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4101 HICKORY HILL LN",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524033740",
            "telephone_number": "319-213-3775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1744 2ND AVE SE",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524032306",
            "telephone_number": "319-366-4673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "DIANA",
        "middle_name": "SUE",
        "name_prefix": "Ms.",
        "credential": "LMHC, CADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-25",
        "last_updated": "2019-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IA",
            "license": "14116",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IA",
            "license": "079713",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• J and J Musick Inc (Medical Pharmacy)
• Julie Jack, LMFT
• Bryce Jackman
• Amy Jackson, LISW
• Bethany Jackson, LMSW
• Diane Marie Jackson, MOT, OTR/L
• Stephanie Colleen Jackson, M.D.
• Lauren Leigh Jacobi, PHARMD
• Benjamin Nathaniel Jacobs, DO
• Eric G Jacobs

• Mental Health Counselor in Cedar Rapids, IA
• Providers in Cedar Rapids, IA by specialty
• Mental Health Counselor in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2019; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.