Bronte Niccole Jackson, LGPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LGP9959 Issued in MD

Practice address

6508 Deer Pointe Dr # 4C
Salisbury, MD 21804-1668

Phone

(410) 742-6016

NPI assigned

Feb 24, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

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

Medicare enrollment (NPD)

Enrolled

State licenses

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 and National Provider Directory roles.

• The Personal Wellness Center

  • Mental Health Counselor
  • Salisbury, MD
  • NPI 1093050890
  Medicare reassignment NPD
• Maryland Wellness LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Baltimore, MD
  • NPI 1588379739
  Medicare reassignment

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

{
    "created_epoch": "1645660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645660800000",
    "number": "1942956388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6508 DEER POINTE DR # 4C",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218041668",
            "telephone_number": "410-742-6016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6508 DEER POINTE DR # 4C",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218041668",
            "telephone_number": "410-742-6016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "BRONTE",
        "middle_name": "NICCOLE",
        "name_prefix": "Mrs.",
        "credential": "LGPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-24",
        "last_updated": "2022-02-24",
        "certification_date": "2022-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": "LGP9959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jane Ngozi Iwebo, PMHNP
• J H Cutchin MD PC
• J O Meadows MD PA
• J. David Collins & Associates
• Jack L Snitzer, D.O., P.a.
• Chardae Jackson
• Darrell M Jackson
• Shiri R Jackson, PHARMD
• Nasima Neelofer Jaffery, M.D.
• Syed Jaffery, MD

• Mental Health Counselor in Salisbury, MD
• Providers in Salisbury, MD by specialty
• Mental Health Counselor in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.