Terronda Lanae Jackson, MA, LPCA

Primary specialty

CounselorTaxonomy code 101Y00000X

License

6574 Issued in SC

Practice address

140 Hunters Run Dr
Blythewood, SC 29016-9206

Phone

(803) 814-7115

NPI assigned

Dec 17, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 5

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in SC

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

Specialty

Mental Health Counselor

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

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.

• It'S Your Move

  • Counselor
  • Columbia, SC
  • NPI 1396214987
  Medicare reassignment NPD
• True Light Counseling and Consulting

  • Professional Counselor
  • Blythewood, SC
  • NPI 1942774955
  NPD Authorized official
• It'S Your Move

  • Primary Care Clinic/Center
  • Columbia, SC
  • NPI 1568114999
  NPD

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

{
    "created_epoch": "1545004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545004800000",
    "number": "1992276810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 HUNTERS RUN DR",
            "city": "BLYTHEWOOD",
            "state": "SC",
            "postal_code": "290169206",
            "telephone_number": "302-265-5993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 HUNTERS RUN DR",
            "city": "BLYTHEWOOD",
            "state": "SC",
            "postal_code": "290169206",
            "telephone_number": "803-814-7115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "TERRONDA",
        "middle_name": "LANAE",
        "name_prefix": "Mrs.",
        "credential": "MA, LPCA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-12-17",
        "last_updated": "2018-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "SC",
            "license": "6574",
            "primary": false
        },
        {
            "code": "101YP1600X",
            "taxonomy_group": "",
            "desc": "Counselor, Pastoral",
            "state": "SC",
            "license": "6574",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "SC",
            "license": "6574",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "SC",
            "license": "6574",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "SC",
            "license": "6574",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LPCA",
            "identifier": "6574",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE PRIME",
            "identifier": "1045081474",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Virginia McCorkle Hutto, LISW-CP
• Nina Hyvarinen Jones, DDS
• Ja Transport
• Adrienne Michelle Jackson, LISW-CP
• Norward Earl Jackson
• John C Cosby Jr DMD PA
• Calvin D Johnson Jr., LCMT
• Miyuki Maureen Johnson
• Shyteria Jones
• Tracee Latashia Smith Jones, PT

• Counselor in Blythewood, SC
• Providers in Blythewood, SC by specialty
• Counselor in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2018; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.