Andrea Beth Jackson, LMFT-ASSOCIATE

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

204092 Issued in TX

Practice address

8216 Irish Dr
North Richland Hills, TX 76180-5530

Phone

(817) 307-8401

NPI assigned

Aug 25, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1629849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629849600000",
    "number": "1992472153",
    "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",
            "telephone_number": "512-318-2199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8216 IRISH DR",
            "city": "NORTH RICHLAND HILLS",
            "state": "TX",
            "postal_code": "761805530",
            "telephone_number": "817-307-8401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "ANDREA",
        "middle_name": "BETH",
        "credential": "LMFT-ASSOCIATE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-25",
        "last_updated": "2021-08-25",
        "certification_date": "2021-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "204092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine Inchausti
• Integrity Consulting & Training Services, LLC
• Integrity Cryo and Recovery LLC
• Interim Woodlands TX
• Ivory Bliss PC
• Brentom E. Jackson, LPC
• Daiquri Jackson
• Samantha Jackson, LVN
• Mira Hardevsinh Jadeja, PHARM D
• Marilin R Jakubowske, SOCIAL WORKER

• Mental Health Counselor in North Richland Hills, TX
• Providers in North Richland Hills, TX by specialty
• Mental Health Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 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.

Verify at the official NPI Registry.