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KELLY COLLEEN JACKSON CDPT
NPI 1629544655
Counselor - Addiction (Substance Use Disorder) in Everett, WA

Active since October 17, 2018
811 MADISON ST, EVERETT, WA 98203(425) 212-4200(425) 212-4201 Get Directions Write a Review

NPPES record last updated: May 13, 2019. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 13, 2019, Oct 17, 2018 (2 updates tracked since 2018).

About Kelly Colleen Jackson Cdpt NPPES

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

KELLY COLLEEN JACKSON CDPT (NPI 1629544655) is an individual addiction (substance use disorder) provider in Everett, Washington, licensed in Washington (CO60869651) and active in the NPI registry since October 2018.

NPPES Registry Identity

NPI1629544655
Entity TypeIndividualFemale
Primary Taxonomy101YA0400X
Provider Legal NameKELLY COLLEEN JACKSONCredential: CDPT
Location Address811 MADISON STEverett, WA 98203-4543
Mailing AddressPo Box 2569Everett, WA 98213-0569 · (425) 212-4200 · Fax (425) 212-4201
Phone(425) 212-4200
Fax(425) 212-4201
Sole ProprietorNo
Enumeration DateOctober 17, 2018
Last NPPES UpdateMay 13, 20192 updates tracked since enumeration
✔ NPI 1629544655 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
License✔ Licensed in WA · CO60869651
811 MADISON ST, Everett, WA 98203
Open in Google Maps ↗

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.

JANELLE SAVILLE RN
Counselor
811 MADISON ST
EVERETT, WA 98203
Snohomish County (425) 212-4200
ASHLEY DYER
Counselor
811 MADISON ST
EVERETT, WA 98203
Snohomish County (425) 212-4200
BEVERLY J CARMAN SUDP
Counselor (Addiction (Substance Use Disorder))
811 MADISON ST
EVERETT, WA 98203
Snohomish County (425) 212-4200
MS. LAKISHA BEARCAT CORDELIA
Counselor
811 MADISON ST
EVERETT, WA 98203
Snohomish County (425) 212-4200
RYAN ERTMAN
Counselor
811 MADISON ST
EVERETT, WA 98203
Snohomish County (425) 212-4200
RENAE MORSE
Counselor
811 MADISON ST
EVERETT, WA 98203
Snohomish County (425) 347-3149
NATHAN MARTIN SCHMECK
Counselor
811 MADISON ST
EVERETT, WA 98203
Snohomish County (425) 212-4200
MR. JAMES BYRON HARVEY ED.S, MHP, CMHS
Counselor (Mental Health)
811 MADISON ST
EVERETT, WA 98203
Snohomish County (425) 212-4200

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 1629544655. It was assigned to this individual provider in the NPPES registry on October 17, 2018.

Where is Kelly Jackson located?

Kelly Jackson practices at 811 Madison St, Everett, WA 98203. The listed phone number is (425) 212-4200.

What is Kelly Jackson's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

When was this NPI record last updated?

The NPPES record for Kelly Jackson was last updated on May 13, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.