ERICA JACKSON
NPI 1558916577
Counselor - Mental Health in Louisville, KY

Q: What is Erica Jackson's NPI number?

The NPI number for Erica Jackson is 1558916577. It was assigned to this individual provider in the NPPES registry on August 6, 2019.

Q: What is Erica Jackson's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Q: When was this NPI record last updated?

The NPPES record for Erica Jackson was last updated on May 16, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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 August 06, 2019PECOS Enrolled

451 BAXTER AVE STE 201, LOUISVILLE, KY 40204(502) 383-2969 Get Directions Write a Review

NPPES record last updated: May 16, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 16, 2025, Apr 23, 2024, Aug 6, 2019 (3 updates tracked since 2019).

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About Erica Jackson NPPES

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

ERICA JACKSON (NPI 1558916577) is an individual mental health provider in Louisville, Kentucky, licensed in Kentucky (296888) and active in the NPI registry since August 2019. She is enrolled in Medicare PECOS and is a graduate of Other (2019).

NPPES Registry Identity

NPI1558916577

Entity TypeIndividualFemale

Primary Taxonomy101YM0800X

Provider Legal NameERICA JACKSON

Location Address451 BAXTER AVE STE 201Louisville, KY 40204-1177

Mailing Address11103 Indian Legends Dr Apt 202Louisville, KY 40241-3488 · (859) 539-3683

Phone(502) 383-2969

Sole ProprietorYes

Medical School CMSOtherGraduated 2019

Enumeration DateAugust 6, 2019

Last NPPES UpdateMay 16, 20253 updates tracked since enumeration

NPPES CertifiedMay 16, 2025

✔ NPI 1558916577 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers

Taxonomy Code101YM0800X

License✔ Licensed in KY · 296888

Also ListedCase Manager/Care CoordinatorTaxonomy 171M00000X

Also ListedDriverTaxonomy 172A00000X

451 BAXTER AVE STE 201, Louisville, KY 40204

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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Erica Jackson is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID7911490958

PECOS Enrollment IDI20251208000800

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.

Other Providers at the Same Location NPPES 5

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

MARTIN AND MUIR COUNSELING INC

Community/Behavioral Health