Active NPI
Ralissa Jackson, LAC
- Addiction (Substance Use Disorder) Counselor
- Billings, MT
National Provider Identifier
1992563050
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 70320
- Practice address
- 1231 N 29TH St
Billings, MT 59101-0147 - Phone
- (406) 248-3175
- NPI assigned
- Mar 12, 2024
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 70320 | MT | Primary |
Addresses
Primary practice location
1231 N 29TH St
Billings, MT 59101-0147
Mailing address
616 N 16TH St
Billings, MT 59101-0416
Phone (406) 707-4479
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 |
|---|---|---|---|
| 70320 | MT | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1710201600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1710201600000",
"number": "1992563050",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "616 N 16TH ST",
"city": "BILLINGS",
"state": "MT",
"postal_code": "591010416",
"telephone_number": "406-707-4479"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1231 N 29TH ST",
"city": "BILLINGS",
"state": "MT",
"postal_code": "591010147",
"telephone_number": "406-248-3175"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "RALISSA",
"credential": "LAC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-03-12",
"last_updated": "2024-03-12",
"certification_date": "2024-03-12",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "MT",
"license": "70320",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Billings, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.