Active NPI
Charlene Jackson
- Mental Health Counselor
- Austin, TX
National Provider Identifier
1982377040
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 81162
- Practice address
- 5900 Balcones Dr Ste 100
Austin, TX 78731-4298 - Phone
- (337) 424-6841
- NPI assigned
- Jul 26, 2021
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 81162 | TX | |
| Mental Health Counselor | 101YM0800X | 81162 | TX | Primary |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 15426 | TX |
Addresses
Primary practice location
5900 Balcones Dr Ste 100
Austin, TX 78731-4298
Mailing address
5900 Balcones Dr Ste 100
Austin, TX 78731-4298
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 |
|---|---|---|---|
| 15426 | TX | MD | Addiction (Substance Use Disorder) Counselor |
| 81162 | TX | MD | Hearing Instrument Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1627257600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1627257600000",
"number": "1982377040",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5900 BALCONES DR STE 100",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787314298"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5900 BALCONES DR STE 100",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787314298",
"telephone_number": "337-424-6841"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "CHARLENE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-07-26",
"last_updated": "2021-07-26",
"certification_date": "2021-07-26",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "81162",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "TX",
"license": "81162",
"primary": true
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "TX",
"license": "15426",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.