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JUSTIN JACKSON LPC
NPI 1235788902
Counselor - Professional in Glen Allen, VA

Active since September 05, 2019PECOS EnrolledAccepts Medicare Assignment
4212 PARK PLACE CT, GLEN ALLEN, VA 23060(804) 332-5950(804) 728-1086 Get Directions Write a Review

NPPES record last updated: August 20, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Aug 20, 2021, Sep 5, 2019 (2 updates tracked since 2019).

About Justin Jackson Lpc NPPES

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

JUSTIN JACKSON LPC (NPI 1235788902) is an individual professional provider in Glen Allen, Virginia, licensed in Virginia (0701008565) and active in the NPI registry since September 2019. He is enrolled in Medicare PECOS and is a graduate of Other (2013).

NPPES Registry Identity

NPI1235788902
Entity TypeIndividualMale
Primary Taxonomy101YP2500X
Provider Legal NameJUSTIN JACKSONCredential: LPC
Location Address4212 PARK PLACE CTGlen Allen, VA 23060-3314
Mailing Address4212 Park Place CtGlen Allen, VA 23060-3314 · (804) 332-5950 · Fax (804) 728-1086
Phone(804) 332-5950
Fax(804) 728-1086
Sole ProprietorNo
Medical School CMSOtherGraduated 2013
Enumeration DateSeptember 5, 2019
Last NPPES UpdateAugust 20, 20212 updates tracked since enumeration
NPPES CertifiedAugust 20, 2021
✔ NPI 1235788902 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in VA · 0701008565
Also ListedCounselorTaxonomy 101Y00000X · License 0701008565 (VA)
Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X · License 0701008565 (VA)
Also ListedCounselor · Mental HealthTaxonomy 101YM0800X · License 0701008565 (VA)
4212 PARK PLACE CT, Glen Allen, VA 23060
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Justin Jackson Lpc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7113362757
PECOS Enrollment IDI20240305001845
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Group psychotherapy 90853
Group psychotherapy involves individuals discussing their issues in a group setting, led by a professional therapist. It provides a supportive environment where members can learn from each other's experiences, gain different perspectives, and develop new ways to handle challenges.
30 services15 patients

Other Providers at the Same Location NPPES 8

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

KATHERINE LOUISE HASKINS LPC, NCC
Counselor (Professional)
4212 PARK PLACE CT
GLEN ALLEN, VA 23060
Henrico County (804) 315-3135
DR. KIRA MARIE BLEECHER M.D.
Psychiatry & Neurology (Psychiatry)
4212 PARK PLACE CT
GLEN ALLEN, VA 23060
Henrico County (804) 332-5950
MARCI LYNN WAGGONER NP
Nurse Practitioner (Adult Health)
4212 PARK PLACE CT
GLEN ALLEN, VA 23060
Henrico County (804) 332-5950
JAMES EDWARD THOMPSON MD
Internal Medicine
4212 PARK PLACE CT
GLEN ALLEN, VA 23060
Henrico County (804) 332-5950
MELODY L IRBY PA-C
Physician Assistant (Medical)
4212 PARK PLACE CT
GLEN ALLEN, VA 23060
Henrico County (804) 332-5950
VIRGINIA CENTER FOR ADDICTION MEDICINE
Internal Medicine (Addiction Medicine)
4212 PARK PLACE CT
GLEN ALLEN, VA 23060
Henrico County (804) 332-5950
MARY ELIZABETH BOWMAN ACNP-BC
Nurse Practitioner (Acute Care)
4212 PARK PLACE CT
GLEN ALLEN, VA 23060
Henrico County (804) 332-5950
BRITTANY ILAGAN HALL AGNP-C
Nurse Practitioner (Primary Care)
4212 PARK PLACE CT
GLEN ALLEN, VA 23060
Henrico County (804) 332-5950

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 Justin Jackson's NPI number?

The NPI number for Justin Jackson is 1235788902. It was assigned to this individual provider in the NPPES registry on September 5, 2019.

Where is Justin Jackson located?

Justin Jackson practices at 4212 Park Place Ct, Glen Allen, VA 23060. The listed phone number is (804) 332-5950.

What is Justin Jackson's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Is Justin Jackson enrolled in Medicare?

Yes. Justin Jackson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Justin Jackson was last updated on August 20, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years 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.