MR. ANTHONY N. JACKSON MA, LPCC, LCADC
NPI 1487210399
Counselor - Professional in Alvaton, KY

Q: What is Anthony Jackson's NPI number?

The NPI number for Anthony Jackson is 1487210399. It was assigned to this individual provider in the NPPES registry on May 15, 2019. The provider is also known as Mr. Jack Jackson Ma, Lpcc, Lcadc.

Q: What is Anthony Jackson's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Anthony Jackson was last updated on October 30, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.

Active since May 15, 2019PECOS Enrolled

6445 EAST HAVEN WAY, ALVATON, KY 42122(502) 509-6116 Get Directions Write a Review

NPPES record last updated: October 30, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 29, 2025, Mar 8, 2023, Aug 19, 2021 and 2 more (5 updates tracked since 2019).

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About Mr. Anthony N. Jackson Ma, Lpcc, Lcadc NPPES

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

MR. ANTHONY N. JACKSON MA, LPCC, LCADC (NPI 1487210399) is an individual professional provider in Alvaton, Kentucky, licensed in Kentucky (297949) and active in the NPI registry since May 2019. He is enrolled in Medicare PECOS, maintains a secondary practice location in Bowling Green, and is a graduate of Other (2022).

NPPES Registry Identity

NPI1487210399

Entity TypeIndividualMale

Primary Taxonomy101YP2500X

Provider Legal NameMR. ANTHONY N. JACKSONCredential: MA, LPCC, LCADC

Location Address6445 EAST HAVEN WAYAlvaton, KY 42122

Mailing Address1143 Fairway St Ste 103Bowling Green, KY 42103-2452 · (407) 347-4536

Phone(502) 509-6116

Sole ProprietorNo

Medical School CMSOtherGraduated 2022

Enumeration DateMay 15, 2019

Last NPPES UpdateOctober 30, 20255 updates tracked since enumeration

NPPES CertifiedOctober 30, 2025

✔ NPI 1487210399 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers

Taxonomy Code101YP2500X

License✔ Licensed in KY · 297949

Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X · License 280595 (KY)

6445 EAST HAVEN WAY, Alvaton, KY 42122

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Other Names 1

Other Name (5)Mr. Jack Jackson Ma, Lpcc, Lcadc

Secondary Practice Location 1

Location 11143 Fairway St Ste 103Bowling Green, KY 42103-2452 · Phone (407) 347-4539

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Providence Health Plan.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Anthony N. Jackson Ma, Lpcc, Lcadc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID5991296832

PECOS Enrollment IDI20251118003781

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.

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 Anthony Jackson's NPI number?

The NPI number for Anthony Jackson is 1487210399. It was assigned to this individual provider in the NPPES registry on May 15, 2019. The provider is also known as Mr. Jack Jackson Ma, Lpcc, Lcadc.

Where is Anthony Jackson located?

Anthony Jackson practices at 6445 East Haven Way, Alvaton, KY 42122. The listed phone number is (502) 509-6116.

What is Anthony Jackson's specialty?

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

Is Anthony Jackson enrolled in Medicare?

Yes. Anthony Jackson is registered in the Medicare PECOS enrollment system.

What insurance does Anthony Jackson accept?

Health plans from Providence Health Plan list Anthony 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 Anthony Jackson was last updated on October 30, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.