MARY JACKSON LCPC, LCAC, LPC
NPI 1184009367
Counselor - Professional in Grand Junction, CO
About Mary Jackson Lcpc, Lcac, Lpc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MARY JACKSON LCPC, LCAC, LPC (NPI 1184009367) is an individual professional provider in Grand Junction, Colorado, licensed in Kansas (2738) and active in the NPI registry since July 2015. She has opted out of Medicare through March 21, 2028.
NPPES Registry Identity
Specialties & Licenses 2
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Opted out of Medicare
Mary Jackson Lcpc, Lcac, Lpc has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from March 21, 2024 through March 21, 2028.
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 Mary Jackson's NPI number?
The NPI number for Mary Jackson is 1184009367. It was assigned to this individual provider in the NPPES registry on July 29, 2015.
Where is Mary Jackson located?
Mary Jackson practices at 2148 Broadway Ste C5, Grand Junction, CO 81507. The listed phone number is (970) 230-3559.
What is Mary Jackson's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.
Is Mary Jackson enrolled in Medicare?
No. Mary Jackson has opted out of Medicare through March 21, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.
What insurance does Mary Jackson accept?
Health plans from Blue Cross and Blue Shield of Kansas, Inc. and UnitedHealthcare list Mary Jackson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Mary Jackson was last updated on June 3, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months 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.
# Mary Jackson, LCPC, LCAC, LPC · NPI 1184009367
Professional provider in Grand Junction, Colorado. Individual provider, active in the CMS NPPES registry since July 29, 2015.
## Identity
- **NPI:** 1184009367 (Entity type: Individual)
- **Enumerated:** July 29, 2015
- **Primary specialty:** Counselor - Professional · taxonomy 101YP2500X
- **State license:** 2738 (Kansas)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 2148 BROADWAY STE C5, Grand Junction, CO 81507-1098
- **Phone:** (970) 230-3559
## Medicare
- **Medicare:** Opted out of Medicare (opt-out affidavit on file, in effect through March 21, 2028); services are provided under private contract
## Record status
- **NPPES last updated:** June 3, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1184009367) · Data from the CMS NPPES public registry.