Active NPI
Carol Jackson
- Professional Counselor
- Arlington, TX
National Provider Identifier
1902510878
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 81052
- Practice address
- 2912 Little Rd
Arlington, TX 76016-1725 - Phone
- (817) 457-6728
- NPI assigned
- Jan 5, 2023
- Last updated
- Jan 19, 2023
- Sex
- Female
- Sole proprietor
- No
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 | 81052 | TX | Primary |
Addresses
Primary practice location
2912 Little Rd
Arlington, TX 76016-1725
Mailing address
2912 Little Rd
Arlington, TX 76016-1725
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 81052 | TX | MD | Hearing Instrument Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lake Arlington Baptist Church | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Impact Counseling & Guidance Center
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Arlington, TX
- NPI 1831365634
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1672876800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1674086400000",
"number": "1902510878",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2912 LITTLE RD",
"city": "ARLINGTON",
"state": "TX",
"postal_code": "760161725"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2912 LITTLE RD",
"city": "ARLINGTON",
"state": "TX",
"postal_code": "760161725",
"telephone_number": "817-457-6728"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "CAROL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-01-05",
"last_updated": "2023-01-19",
"certification_date": "2023-01-19",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "81052",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Arlington, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.