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MRS. KIM MARIE JACKSON
NPI 1285933176
Counselor in Wagoner, OK

Active since March 18, 2011
2109 S HIGHWAY 69, WAGONER, OK 74467(918) 485-0242(918) 485-0204 Get Directions Write a Review

NPPES record last updated: March 18, 2011. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Mrs. Kim Marie Jackson NPPES

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

MRS. KIM MARIE JACKSON (NPI 1285933176) is an individual counselor in Wagoner, Oklahoma and active in the NPI registry since March 2011.

NPPES Registry Identity

NPI1285933176
Entity TypeIndividualFemale
Primary Taxonomy101Y00000X
Provider Legal NameMRS. KIM MARIE JACKSON
Location Address2109 S HIGHWAY 69Wagoner, OK 74467-9310
Mailing Address2109 S Highway 69Wagoner, OK 74467-9310 · (918) 485-0242 · Fax (918) 485-0204
Phone(918) 485-0242
Fax(918) 485-0204
Sole ProprietorYes
Enumeration DateMarch 18, 2011
✔ NPI 1285933176 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.
2109 S HIGHWAY 69, Wagoner, OK 74467
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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.

MELISSA ELLIS
Case Manager/Care Coordinator
2109 S HIGHWAY 69
WAGONER, OK 74467
Wagoner County (918) 342-0770
ANGELINA C HAYES
Counselor
2109 S HIGHWAY 69
WAGONER, OK 74467
Wagoner County (918) 485-0242
RACHEL PENTLAND MA
Counselor (Mental Health)
2109 S HIGHWAY 69
WAGONER, OK 74467
Wagoner County (918) 708-3006
CRYSTAL RENEE SMITH
Counselor (Mental Health)
2109 S HIGHWAY 69
WAGONER, OK 74467
Wagoner County (918) 640-0199
MS. ALISHA TRICKEY
Case Manager/Care Coordinator
2109 S HIGHWAY 69
WAGONER, OK 74467
Wagoner County (918) 342-0770
ELIZABETH LANE MASON BSW
Case Manager/Care Coordinator
2109 S HIGHWAY 69
WAGONER, OK 74467
Wagoner County (918) 708-3006
LINDSEY SARVER CHES
Case Manager/Care Coordinator
2109 S HIGHWAY 69
WAGONER, OK 74467
Wagoner County (918) 708-3006
GRAND LAKE MENTAL HEALTH CENTER, INC.
Clinic/Center (Mental Health (Including Community Mental Health Center))
2109 S HIGHWAY 69
WAGONER, OK 74467
Wagoner County (918) 273-1841

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 Kim Jackson's NPI number?

The NPI number for Kim Jackson is 1285933176. It was assigned to this individual provider in the NPPES registry on March 18, 2011.

Where is Kim Jackson located?

Kim Jackson practices at 2109 S Highway 69, Wagoner, OK 74467. The listed phone number is (918) 485-0242.

What is Kim 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 Kim Jackson was last updated on March 18, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.