Vanessa Michelle Jackson

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

11754 Jollyville Rd Ste 110
Austin, TX 78759-3948

Phone

(512) 331-2700

Fax

(512) 665-5796

NPI assigned

Nov 30, 2018

Last updated

Sep 26, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Adjuvant Behavioral Health IncGroup PAC ID 2860865557, 15 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Adjuvant Behavioral Health Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Austin, TX
  • NPI 1497485106
  Medicare reassignment Care Compare group NPD
• Adjuvant Behavioral Health Inc

  • Physician Assistant
  • Verona, NJ
  • NPI 1851266605
  NPD

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

{
    "created_epoch": "1543536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727308800000",
    "number": "1932679172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11754 JOLLYVILLE RD STE 110",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787593948",
            "telephone_number": "512-331-2700",
            "fax_number": "512-665-5796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11754 JOLLYVILLE RD STE 110",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787593948",
            "telephone_number": "512-331-2700",
            "fax_number": "512-665-5796"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4220 Monterey Oaks Blvd Ste 320",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "787491170",
            "country_code": "US",
            "telephone_number": "512-331-2700 x708",
            "fax_number": "512-219-5097",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "VANESSA",
        "middle_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-30",
        "last_updated": "2024-09-26",
        "certification_date": "2024-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Jackson
• Susan Jean Jackson, PT
• Tomecia Jackson
• Tonce Jackson
• Tryna Jackson
• Victoria Lynn Jackson, M.N.S., CCC-SLP
• Yaminah Jackson
• Zoe Jackson
• Deepa Jacob
• Jennifer Jacob, RBT

• Mental Health Counselor in Austin, TX
• Providers in Austin, TX by specialty
• Mental Health Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2024; 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.