Active NPI
Dana Lynn Jackson, LADC UNDER SUPER
- Mental Health Counselor
- Tulsa, OK
National Provider Identifier
1962701391
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 2448 E. 81St Street
Suite 4824 / Citiplextowers
Tulsa, OK 74137-1814 - Phone
- (918) 486-9996
- NPI assigned
- Mar 24, 2011
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
2448 E. 81St Street
Suite 4824 / Citiplextowers
Tulsa, OK 74137-1814
Mailing address
2413 Larkhaven St
Norman, OK 73071-4326
Phone (405) 310-6108
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P082039069 | Medicaid | OK |
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": "1300924800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1318636800000",
"number": "1962701391",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2413 LARKHAVEN ST",
"city": "NORMAN",
"state": "OK",
"postal_code": "730714326",
"telephone_number": "405-310-6108"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2448 E. 81ST STREET",
"address_2": "SUITE 4824 / CITIPLEXTOWERS",
"city": "TULSA",
"state": "OK",
"postal_code": "741371814",
"telephone_number": "918-486-9996"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "DANA",
"middle_name": "LYNN",
"name_prefix": "Mrs.",
"credential": "LADC UNDER SUPER",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-03-24",
"last_updated": "2011-10-15",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "P082039069",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tulsa, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.