Newly Listed Provider — this NPI profile has been added to the NPI registry within the last 90 days.

SAMANTHA JO JACKSON LPC
NPI 1053215459
Counselor - Mental Health in Canton, IL

Q: What is Samantha Jackson's NPI number?

The NPI number for Samantha Jackson is 1053215459. It was assigned to this individual provider in the NPPES registry on October 7, 2026.

Q: What is Samantha Jackson's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Q: When was this NPI record last updated?

The NPPES record for Samantha Jackson was last updated on October 7, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since October 07, 2026

8 S MAIN ST, CANTON, IL 61520(309) 740-2171 Get Directions Write a Review

NPPES record added: October 7, 2026. Verified against the NPPES registry weekly; last sync: October 11, 2026.

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About Samantha Jo Jackson Lpc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SAMANTHA JO JACKSON LPC (NPI 1053215459) is an individual mental health provider in Canton, Illinois, licensed in Illinois (178.033548) and active in the NPI registry since October 2026.

NPPES Registry Identity

NPI1053215459

Entity TypeIndividualFemale

Primary Taxonomy101YM0800X

Provider Legal NameSAMANTHA JO JACKSONCredential: LPC

Location Address8 S MAIN STCanton, IL 61520-2606

Mailing Address115 Linden StCanton, IL 61520-1114

Phone(309) 740-2171

Sole ProprietorNo

Enumeration DateOctober 7, 2026

NPPES CertifiedOctober 7, 2026

✔ NPI 1053215459 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers

Taxonomy Code101YM0800X

License✔ Licensed in IL · 178.033548

8 S MAIN ST, Canton, IL 61520

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Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. NATHAN W GATES MA

Counselor (Professional)

8 S MAIN ST, SUITE 203
CANTON, IL 61520

Fulton County (309) 740-2171

JEANINE STANDARD METAMORPHOSIS INC

Psychologist (Clinical)

8 S MAIN ST, SUITE 205
CANTON, IL 61520

Fulton County (309) 740-2171

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Samantha Jackson's NPI number?

The NPI number for Samantha Jackson is 1053215459. It was assigned to this individual provider in the NPPES registry on October 7, 2026.

Where is Samantha Jackson located?

Samantha Jackson practices at 8 S Main St, Canton, IL 61520. The listed phone number is (309) 740-2171.

What is Samantha Jackson's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

When was this NPI record last updated?

The NPPES record for Samantha Jackson was last updated on October 7, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.