Tiffany Jackson, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

A1308078 Issued in AR

Practice address

312 SW Greenwich Dr Ste 579
Lees Summit, MO 64082-4408

Phone

(870) 413-6905

NPI assigned

Nov 6, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• BHC Pinnacle Pointe Hospital LLC

  • Psychiatric Hospital
  • Little Rock, AR
  • NPI 1912962341
  NPD (past)
• Uhs of Benton, Inc.

  • Adolescent and Children Mental Health Clinic/Center
  • Pine Bluff, AR
  • NPI 1699845818
  NPD (past)

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

{
    "created_epoch": "1415232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759190400000",
    "number": "1992101752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "312 SW GREENWICH DR STE 579",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640824408",
            "telephone_number": "870-413-6905",
            "fax_number": "870-515-4029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "312 SW GREENWICH DR STE 579",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640824408",
            "telephone_number": "870-413-6905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "TIFFANY",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-11-06",
        "last_updated": "2025-09-30",
        "certification_date": "2025-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MO",
            "license": "2021012242",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AR",
            "license": "P1607095",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AR",
            "license": "A1308078",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Courtney J Jack, APRN-BC
• Jackson County Eye Clinic Inc.
• Julie Jackson, PHARMD
• Melanie L Jackson, MOTR/L, CHT
• Tammy J Jackson, LICENSED PSYCHOLOGIS
• Jacob a Laudie DDS LLC
• Jessica M Jacobs
• Rachel Jaggard
• Aniket Maheshkumar Jaimalani, M.D.
• James D. Schuette, D.D.S., P. C.

• All providers in Lees Summit, MO
• Mental Health Counselor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2025; 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.