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TISHARA A. JACKSON ED.D, LCDC, CSC
NPI 1477319119
Counselor - Mental Health in Fort Worth, TX

Active since February 21, 2024
8201 SOUTHBROOK CIR, FORT WORTH, TX 76134(773) 996-3797 Get Directions Write a Review

NPPES record last updated: April 2, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Tishara A. Jackson Ed.d, Lcdc, Csc NPPES

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

TISHARA A. JACKSON ED.D, LCDC, CSC (NPI 1477319119) is an individual mental health provider in Fort Worth, Texas, licensed in Texas (15299) and active in the NPI registry since February 2024.

NPPES Registry Identity

NPI1477319119
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameTISHARA A. JACKSONCredential: ED.D, LCDC, CSC
Location Address8201 SOUTHBROOK CIRFort Worth, TX 76134-5332
Mailing Address5613 Mount Storm WayFort Worth, TX 76179-4438 · (773) 996-3797
Phone(773) 996-3797
Sole ProprietorNo
Enumeration DateFebruary 21, 2024
Last NPPES UpdateApril 2, 2025
NPPES CertifiedApril 2, 2025
✔ NPI 1477319119 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 TX · 15299
8201 SOUTHBROOK CIR, Fort Worth, TX 76134
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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 Tishara Jackson's NPI number?

The NPI number for Tishara Jackson is 1477319119. It was assigned to this individual provider in the NPPES registry on February 21, 2024.

Where is Tishara Jackson located?

Tishara Jackson practices at 8201 Southbrook Cir, Fort Worth, TX 76134. The listed phone number is (773) 996-3797.

What is Tishara 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 Tishara Jackson was last updated on April 2, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.