JACKSON PSYCHOTHERAPY, LLC (NPI# 1578064861) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578064861 |
| Entity Type | Organization |
| Organization Name | JACKSON PSYCHOTHERAPY, LLC |
| Practice Address |
901 Kentucky St Ste 306 Lawrence KS 66044-2858 |
| Practice Telephone | 8163777398 |
| Practice Fax Number | 8168731364 |
| Mailing Telephone | 8163777398 |
| Mailing Fax Number | 8163777398 |
| Enumeration Date | 2018-02-22 |
| Last Update Date | 2018-02-22 |
| Authorized Official Name | REGINALD C. JACKSON (OWNER/PSYCHOTHERAPIST) |
| Authorized Official Telephone | 8163777398 |
| Authorized Official Credential | LSCSW, LCSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
4352 | KS | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 2015021883 | 05 | |
| KS | 4352 | 05 | |
| KS | BCBS | 4352 | 01 |
| MO | BCBS OF KANSAS CITY | 2015021883 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154846533 | Jackson Psychotherapy, LLC | Social Worker | 901 Kentucky St Ste 306, Lawrence, KS 66044-2858 | 2017-08-07 |
| Street Address |
901 KENTUCKY ST STE 306 |
| City | LAWRENCE |
| State | KS |
| Zip Code | 66044-2858 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720107535 | Alicia Marie Lawrence | Social Worker | 901 Kentucky St Ste 306, Lawrence, KS 66044-2858 | 2007-03-29 |
| 1801446117 | Jonathan Blum | Social Worker | 901 Kentucky St Ste 306, Lawrence, KS 66044-2858 | 2019-09-18 |
| 1154846533 | Jackson Psychotherapy, LLC | Social Worker | 901 Kentucky St Ste 306, Lawrence, KS 66044-2858 | 2017-08-07 |
| 1548620271 | Sandra Dexter | Social Worker | 901 Kentucky St Ste 306, Lawrence, KS 66044-2858 | 2016-02-23 |
| 1639454622 | Lawrence Family Therapy, LLC | Social Worker | 901 Kentucky St Ste 306, Lawrence, KS 66044-2858 | 2011-10-21 |
| 1750618336 | Reginald Christopher Jackson | Social Worker | 901 Kentucky St Ste 306, Lawrence, KS 66044-2858 | 2009-11-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770041766 | Leslie Lynne Snow | Radiology | 325 Maine St Lawrence, Ks 66044, Lawerence, KS 66044 | 2019-03-08 |
| 1316439409 | Marjorie R Cooper Paschang | Counselor | 841 1/2 Massachusetts St Ste D, Lawrence, KS 66044 | 2018-06-04 |
| 1497255004 | Social Perspective, LLC | Social Worker | 211 E. 8th Street, #c, Lawrence, KS 66044 | 2018-02-20 |
| 1164920955 | Abby Hein | Pharmacist | 325 Maine Street, Pharmacy Dept, Lawrence, KS 66044 | 2018-01-26 |
| 1922515899 | The Magnolia Institute, LLC | Community/Behavioral Health | 729 1/2 Massachusetts. St., Suite 215, Lawrence, KS 66044 | 2018-01-02 |
| 1538615190 | Atma Clinic, LLC | Clinic/Center | 920 Massachusetts St. Ste. 3, Lawrence, KS 66044 | 2016-09-01 |
| 1497119499 | Anne Ferguson | Pharmacist | 1025 N 3rd St Ste 110, Heartland Homecare, Lawrence, KS 66044 | 2016-04-06 |
| 1467826180 | Americare At Monterey Village Assited Living LLC | Assisted Living Facility | 3901 Peterson Road, Lawrence, KS 66044 | 2015-11-18 |
| 1669886008 | Spencer Harrison | Psychiatry & Neurology | 1130 W 4th St Ste 3200, Lawrence, KS 66044 | 2014-06-13 |
| 1245658715 | Patrick Harper | Anesthesiology | 330 Arkansas St Ste 201, Lawrence, KS 66044 | 2014-04-02 |
| Find all providers in zip 66044 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942826003 | Courage Counseling LLC | Clinic/Center | 729 1/2 Massachusetts St Ste 214, Lawrence, KS 66044-2257 | 2020-06-24 |
| 1114290814 | New England Assessment Services, Inc | Clinic/Center | 599 Canal St Ste 416, Lawrence, MA 01840-1244 | 2012-02-12 |
| 1679680615 | Family Services of The Merrimack Valley, Inc. | Clinic/Center | 430 N Canal St, Lawrence, MA 01840-1246 | 2006-08-24 |
| 1841281805 | Bert Nash Community Mental Health Center Inc | Clinic/Center | 200 Maine St, Ste A, Lawrence, KS 66044-1368 | 2005-10-31 |
| 1447760558 | Susan Miller Counseling LLC | Clinic/Center | 2001 Haskell Ave, Lawrence, KS 66046-3249 | 2017-10-03 |
| 1003326349 | Kate Rylander Counseling LLC | Clinic/Center | 2001 Haskell Ave, Lawrence, KS 66046-3249 | 2017-09-30 |
| 1659820660 | Bert Nash Cmhc Inc | Clinic/Center | 200 Maine St, Suite A, Lawrence, KS 66044-1368 | 2016-10-03 |
| 1972704203 | University of Kansas | Clinic/Center | 1415 Jayhawk Blvd, 340 Fraser Hall, Lawrence, KS 66045-7556 | 2007-05-31 |
| 1881811867 | Dccca, Inc | Clinic/Center | 3312 Clinton Pkwy, Lawrence, KS 66047-3624 | 2007-04-19 |
| 1093783912 | Bert Nash Community Mental Health Center Inc | Clinic/Center | 200 Maine, Ste A, Lawrence, KS 66044 | 2006-03-08 |
| Find all providers in LAWRENCE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.