CALVIN JACKSON LPA
NPI 1649226549
Counselor - Mental Health in Elizabethtown, KY

Q: What is the provider's specialty?

The provider's specialty is Counselor with taxonomy code 101YM0800X and a focus in Mental Health.

Active since May 25, 2006

1311 N DIXIE HWY, ELIZABETHTOWN, KY 42701(270) 769-1304(270) 234-8028 Get Directions Write a Review

NPPES record last updated: March 29, 2008. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Calvin Jackson Lpa NPPES

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

CALVIN JACKSON LPA (NPI 1649226549) is an individual mental health provider in Elizabethtown, Kentucky, licensed in Kentucky (0274) and active in the NPI registry since May 2006.

NPPES Registry Identity

NPI1649226549

Entity TypeIndividualMale

Primary Taxonomy101YM0800X

Provider Legal NameCALVIN JACKSONCredential: LPA

Location Address1311 N DIXIE HWYElizabethtown, KY 42701-2621

Mailing Address107 Cranes Roost CtElizabethtown, KY 42701-3650 · (270) 765-2605 · Fax (270) 766-1222

Phone(270) 769-1304

Fax(270) 234-8028

Sole ProprietorNo

Enumeration DateMay 25, 2006

Last NPPES UpdateMarch 29, 2008

✔ NPI 1649226549 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 KY · 0274

1311 N DIXIE HWY, Elizabethtown, KY 42701

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Other Identifiers 2

Medicaid30605018KS

Other000000338946KY · Anthem

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.

CARLA A MACKEY LMFT

Counselor (Mental Health)