Individual provider Active NPI

Tawanna Jackson

  • Mental Health Counselor
  • Statesboro, GA
National Provider Identifier
1952225138
Registry record updated Aug 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
1 S College St # 2405
Statesboro, GA 30458-4856
Phone
(912) 228-0068
NPI assigned
Aug 8, 2026
Last updated
Aug 8, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 8, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU Primary

Addresses

Primary practice location

1 S College St # 2405
Statesboro, GA 30458-4856

Mailing address

1 S College St # 2408
Statesboro, GA 30458-4856

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

NPI Registry JSON

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

{
    "created_epoch": "1786147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786147200000",
    "number": "1952225138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 S COLLEGE ST # 2408",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304584856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 S COLLEGE ST # 2405",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304584856",
            "telephone_number": "912-228-0068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "TAWANNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-08-08",
        "last_updated": "2026-08-08",
        "certification_date": "2026-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Statesboro, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.