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KELLY JACKSON
NPI 1518274240
Counselor - Mental Health in Philadelphia, PA

Active since September 01, 2010
112 N BROAD ST, PHILADELPHIA, PA 19102(215) 568-0860 Get Directions Write a Review

NPPES record last updated: September 1, 2010. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Kelly Jackson NPPES

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

KELLY JACKSON (NPI 1518274240) is an individual mental health provider in Philadelphia, Pennsylvania and active in the NPI registry since September 2010.

NPPES Registry Identity

NPI1518274240
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameKELLY JACKSON
Location Address112 N BROAD STPhiladelphia, PA 19102-1512
Mailing Address112 N Broad StPhiladelphia, PA 19102-1512 · (215) 568-0860
Phone(215) 568-0860
Sole ProprietorNo
Enumeration DateSeptember 1, 2010
✔ NPI 1518274240 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
112 N BROAD ST, Philadelphia, PA 19102
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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.

BARRI R ISKIN LCSW
Social Worker (Clinical)
112 N BROAD ST, 7TH FL
PHILADELPHIA, PA 19102
Philadelphia County (215) 568-0860
LINDA MARY LIPSON MA, LPC
Counselor
112 N BROAD ST
PHILADELPHIA, PA 19102
Philadelphia County (215) 568-0860
JOEL ESTERMAN MED
Psychologist
112 N BROAD ST, 8TH FL
PHILADELPHIA, PA 19102
Philadelphia County (215) 568-0860
MS. DEBORAH M KLAWITER BS
Counselor
112 N BROAD ST, 8TH FL
PHILADELPHIA, PA 19102
Philadelphia County (215) 568-0860
MS. DONNA M STEWART BS
Counselor
112 N BROAD ST, 8TH FL
PHILADELPHIA, PA 19102
Philadelphia County (215) 568-0860
MS. LAURIE HUME FLINT BA
Counselor
112 N BROAD ST, 8TH FL
PHILADELPHIA, PA 19102
Philadelphia County (215) 568-0860
MRS. ROSA IVETTE VEGA
Counselor
112 N BROAD ST, 8TH FL
PHILADELPHIA, PA 19102
Philadelphia County (215) 568-0860
MR. MARCUS DON WILLIAMS RN
Registered Nurse
112 N BROAD ST, 8TH FL
PHILADELPHIA, PA 19102
Philadelphia County (215) 568-0860

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 Kelly Jackson's NPI number?

The NPI number for Kelly Jackson is 1518274240. It was assigned to this individual provider in the NPPES registry on September 1, 2010.

Where is Kelly Jackson located?

Kelly Jackson practices at 112 N Broad St, Philadelphia, PA 19102. The listed phone number is (215) 568-0860.

What is Kelly 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 Kelly Jackson was last updated on September 1, 2010. NPI Profile syncs with the weekly NPPES data releases published by CMS.