Active NPI
Constance Jackson, LPC
- Professional Counselor
- Albany, GA
National Provider Identifier
1942620547
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPC007780
- Practice address
- 601 11TH Ave
Albany, GA 31701-1645 - Phone
- (229) 430-4140
- Fax
- (229) 430-6077
- NPI assigned
- Apr 22, 2014
- Last updated
- Apr 22, 2014
- 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 | LPC007780 | GA | Primary |
Addresses
Primary practice location
601 11TH Ave
Albany, GA 31701-1645
Mailing address
PO Box 1988
Albany, GA 31702-1988
Phone (229) 430-4002
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 |
|---|---|---|---|
| LPC007780 | GA | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1398124800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1398124800000",
"number": "1942620547",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1988",
"city": "ALBANY",
"state": "GA",
"postal_code": "317021988",
"telephone_number": "229-430-4002",
"fax_number": "229-430-6002"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "601 11TH AVE",
"city": "ALBANY",
"state": "GA",
"postal_code": "317011645",
"telephone_number": "229-430-4140",
"fax_number": "229-430-6077"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "CONSTANCE",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-04-22",
"last_updated": "2014-04-22",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "GA",
"license": "LPC007780",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Albany, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.