Courtney Jackson

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

Practice address

250 Georgia Ave SE
Suite 206
Atlanta, GA 30312

Phone

(202) 441-3364

NPI assigned

Aug 20, 2019

Last updated

Oct 20, 2025By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1566259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760918400000",
    "number": "1992352421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 GEORGIA AVE SE",
            "address_2": "SUITE 206",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 GEORGIA AVE SE",
            "address_2": "SUITE 206",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30312",
            "telephone_number": "202-441-3364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "COURTNEY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-08-20",
        "last_updated": "2025-10-20",
        "certification_date": "2025-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": null,
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "http://www.eastchesterfamilyservices.com/",
            "affiliation": "N",
            "endpointDescription": "http://www.eastchesterfamilyservices.com/",
            "address_1": "250 Georgia Ave SE",
            "address_2": "Suite 206",
            "city": "Atlanta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "30312",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Carlotta Marie Jackson
• Chanda Waller Jackson, NP
• Cherlisa Jackson, MA, MPH, LPC, CHES
• Chesiree Jackson
• Christophe Eugene Jackson, PA
• Danielle Jackson
• Deontae Noel Jackson
• Devane Jackson, RBT
• Eboni Jackson
• Edward Jackson, AA

• Peer Specialist in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Peer Specialist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 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.