1. Home
  2. Directory
  3. South Carolina
  4. Winnsboro
  5. Counselor
  6. NPI Profile

MYCHA I JACKSON LPC
NPI 1649700329
Counselor - Professional in Winnsboro, SC

Active since June 15, 2017PECOS Enrolled
4866 GREENBRIER MOSSYDALE RD, WINNSBORO, SC 29180(803) 800-1701 Get Directions Write a Review

NPPES record last updated: October 10, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Oct 10, 2024, Jun 4, 2024, Jul 21, 2022 and 1 more (4 updates tracked since 2017).

About Mycha I Jackson Lpc NPPES

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

MYCHA I JACKSON LPC (NPI 1649700329) is an individual professional provider in Winnsboro, South Carolina, licensed in South Carolina (9508) and active in the NPI registry since June 2017. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1649700329
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameMYCHA I JACKSONCredential: LPC
Location Address4866 GREENBRIER MOSSYDALE RDWinnsboro, SC 29180-6523
Mailing Address4866 Greenbrier Mossydale RdWinnsboro, SC 29180-6523 · (803) 800-1701
Phone(803) 800-1701
Sole ProprietorNo
Enumeration DateJune 15, 2017
Last NPPES UpdateOctober 10, 20244 updates tracked since enumeration
NPPES CertifiedOctober 10, 2024
✔ NPI 1649700329 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 SC · 9508
Also ListedCounselor · Mental HealthTaxonomy 101YM0800X · License 9508 (SC)
4866 GREENBRIER MOSSYDALE RD, Winnsboro, SC 29180
Open in Google Maps ↗

Other Identifiers 2

Other3335SC · Medicare Pin
Medicaid421504SC

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

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

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 Mycha Jackson's NPI number?

The NPI number for Mycha Jackson is 1649700329. It was assigned to this individual provider in the NPPES registry on June 15, 2017.

Where is Mycha Jackson located?

Mycha Jackson practices at 4866 Greenbrier Mossydale Rd, Winnsboro, SC 29180. The listed phone number is (803) 800-1701.

What is Mycha Jackson's specialty?

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

Is Mycha Jackson enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Mycha Jackson was last updated on October 10, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.