Active NPI
Marcella Jackson, LMSW
- Mental Health Counselor
- Baltimore, MD
National Provider Identifier
1922716711
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 18439
- Practice address
- 8831 Satyr Hill Rd Ste 107
Baltimore, MD 21234-2437 - Phone
- (443) 838-1700
- NPI assigned
- Nov 9, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 18439 | MD | |
| Social Worker | 104100000X | 18439 | MD | |
| Case Management Agency | 251B00000X | 18439 | MD | |
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X | 18439 | MD | |
| Mental Health Counselor | 101YM0800X | 18439 | MD | Primary |
Addresses
Primary practice location
8831 Satyr Hill Rd Ste 107
Baltimore, MD 21234-2437
Mailing address
8831 Satyr Hill Rd Ste 107
Baltimore, MD 21234-2437
Phone (443) 838-1700
Other practice location 1
1829 Reisterstown Rd Ste 350
Pikesville, MD 21208-7126
Phone (443) 838-1700
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 18439 | Other | MD | LICENSE ID |
| 1922716711 | Medicaid | MD |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | mjackson@victorybehavior.com | Direct |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18439 | MD | MD | Professional Counselor |
Organizations & group practices 4
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.
-
- Community/Behavioral Health Agency
- Baltimore, MD
- NPI 1275388043
-
dba VBS - Victory Behavioral Solutions
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Baltimore, MD
- NPI 1336859784
-
- Community/Behavioral Health Agency
- Baltimore, MD
- NPI 1578319166
-
- Community/Behavioral Health Agency
- Baltimore, MD
- NPI 1942056007
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1667952000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1673049600000",
"number": "1922716711",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8831 SATYR HILL RD STE 107",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212342437",
"telephone_number": "443-838-1700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8831 SATYR HILL RD STE 107",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212342437",
"telephone_number": "443-838-1700"
}
],
"practiceLocations": [
{
"address_1": "1829 Reisterstown Rd Ste 350",
"address_purpose": "LOCATION",
"city": "Pikesville",
"state": "MD",
"postal_code": "212087126",
"country_code": "US",
"telephone_number": "443-838-1700",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JACKSON",
"first_name": "MARCELLA",
"credential": "LMSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-11-09",
"last_updated": "2023-01-07",
"certification_date": "2023-01-07",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MD",
"license": "18439",
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MD",
"license": "18439",
"primary": false
},
{
"code": "251B00000X",
"taxonomy_group": "",
"desc": "Case Management",
"state": "MD",
"license": "18439",
"primary": false
},
{
"code": "261QM0801X",
"taxonomy_group": "",
"desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
"state": "MD",
"license": "18439",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MD",
"license": "18439",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE ID",
"identifier": "18439",
"state": "MD"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1922716711",
"state": "MD"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "mjackson@victorybehavior.com",
"affiliation": "N",
"endpointDescription": "Email",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "8831 Satyr Hill Rd Ste 107",
"city": "Baltimore",
"state": "MD",
"country_code": "US",
"postal_code": "212342437",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Baltimore, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 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.