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JOHNATHAN JACKSON BS
NPI 1144961806
Counselor in Carbondale, IL

Active since April 06, 2022
2411 S ILLINOIS AVE, CARBONDALE, IL 62903(855) 608-3560 Get Directions Write a Review

NPPES record last updated: April 6, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Johnathan Jackson Bs NPPES

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

JOHNATHAN JACKSON BS (NPI 1144961806) is an individual counselor in Carbondale, Illinois and active in the NPI registry since April 2022.

NPPES Registry Identity

NPI1144961806
Entity TypeIndividualMale
Primary Taxonomy101Y00000X
Provider Legal NameJOHNATHAN JACKSONCredential: BS
Location Address2411 S ILLINOIS AVECarbondale, IL 62903-5913
Mailing Address902 W Main StWest Frankfort, IL 62896-2210 · (618) 937-6483 · Fax (618) 937-1440
Phone(855) 608-3560
Sole ProprietorNo
Enumeration DateApril 6, 2022
NPPES CertifiedApril 6, 2022
✔ NPI 1144961806 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselorBehavioral Health & Social Service Providers
Taxonomy Code101Y00000X
Definition
A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.
2411 S ILLINOIS AVE, Carbondale, IL 62903
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Other Providers at the Same Location NPPES 20

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

CENTERSTONE OF ILLINOIS, INC
Clinic/Center (Mental Health (Including Community Mental Health Center))
2411 S ILLINOIS AVE
CARBONDALE, IL 62903
Jackson County (618) 937-6483
ALLYSSA KOWALIS
Counselor
2411 S ILLINOIS AVE
CARBONDALE, IL 62903
Jackson County (618) 457-6703
CHANTEL JACOBS
Counselor
2411 S ILLINOIS AVE
CARBONDALE, IL 62903
Jackson County (618) 457-6703
TAYLOR SERRATA
Counselor
2411 S ILLINOIS AVE
CARBONDALE, IL 62903
Jackson County (618) 615-9754
AHMED BUKHAMSIN BS
Counselor
2411 S ILLINOIS AVE
CARBONDALE, IL 62903
Jackson County (618) 457-6703
JAYME ANN MCCARROLL MA
Counselor
2411 S ILLINOIS AVE
CARBONDALE, IL 62903
Jackson County (618) 615-9754
CHELSEA BLIXT
Counselor
2411 S ILLINOIS AVE
CARBONDALE, IL 62903
Jackson County (618) 615-9754
AMANDA SMOCK
Counselor
2411 S ILLINOIS AVE
CARBONDALE, IL 62903
Jackson County (618) 615-9754

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 Johnathan Jackson's NPI number?

The NPI number for Johnathan Jackson is 1144961806. It was assigned to this individual provider in the NPPES registry on April 6, 2022.

Where is Johnathan Jackson located?

Johnathan Jackson practices at 2411 S Illinois Ave, Carbondale, IL 62903. The listed phone number is (855) 608-3560.

What is Johnathan Jackson's specialty?

The primary specialty registered for this NPI is Counselor with taxonomy code 101Y00000X.

When was this NPI record last updated?

The NPPES record for Johnathan Jackson was last updated on April 6, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.