Individual provider Active NPI

Jackson E Powers, LPC

  • Professional Counselor
  • Paragould, AR
National Provider Identifier
1912480195
Registry record updated Jan 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
P2501022 Issued in AR
Practice address
1707 Linwood Dr Ste B
Paragould, AR 72450-5365
Phone
(870) 604-4455
NPI assigned
Sep 13, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X P2501022 AR Primary

Addresses

Primary practice location

1707 Linwood Dr Ste B
Paragould, AR 72450-5365

Mailing address

1707 Linwood Dr Ste B
Paragould, AR 72450-5365
Phone (870) 604-4455

Other identifiers 1

IdentifierTypeStateIssuer
240408795MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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

Enrollment IDStateProvider typePAC IDDetails
I20251216000208 AR Practitioner - Mental Health Counselor 5395239495 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1707 Linwood Dr
Suite B
Paragould, AR 72450-5820

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
P2501022ARMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Nextstep Counseling Services, LLC CurrentSince Oct 5, 2025 Accepting new patients
Families, Inc. of Arkansas PastSince May 1, 2022 Accepting new patients

Locations

1707 Linwood Dr
Ste B
Paragould, AR 72450
Phone (870) 215-0669

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1536796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738108800000",
    "number": "1912480195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1707 LINWOOD DR STE B",
            "city": "PARAGOULD",
            "state": "AR",
            "postal_code": "724505365",
            "telephone_number": "870-604-4455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1707 LINWOOD DR STE B",
            "city": "PARAGOULD",
            "state": "AR",
            "postal_code": "724505365",
            "telephone_number": "870-604-4455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POWERS",
        "first_name": "JACKSON",
        "middle_name": "E",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-09-13",
        "last_updated": "2025-01-29",
        "certification_date": "2025-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AR",
            "license": "P2501022",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "240408795",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Paragould, AR

Sources for this page

Verify at the official NPI Registry.