1. Home
  2. Directory
  3. Virginia
  4. Manassas
  5. Counselor
  6. NPI Profile

KEIRA MICHELLE JACKSON
NPI 1699249839
Counselor - Mental Health in Manassas, VA

Active since January 21, 2019PECOS Enrolled
8601 ROSE MALLOW DR APT 415, MANASSAS, VA 20109(757) 232-9100 Get Directions Write a Review

NPPES record last updated: October 14, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Oct 14, 2022, Jan 21, 2019 (2 updates tracked since 2019).

About Keira Michelle Jackson NPPES

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

KEIRA MICHELLE JACKSON (NPI 1699249839) is an individual mental health provider in Manassas, Virginia, licensed in Virginia (0704014248) and active in the NPI registry since January 2019. She is enrolled in Medicare PECOS and is a graduate of Other (2021).

NPPES Registry Identity

NPI1699249839
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameKEIRA MICHELLE JACKSON
Location Address8601 ROSE MALLOW DR APT 415Manassas, VA 20109-4025
Mailing Address8601 Rose Mallow Dr Apt 415Manassas, VA 20109-4025 · (757) 232-9100
Phone(757) 232-9100
Sole ProprietorYes
Medical School CMSOtherGraduated 2021
Enumeration DateJanuary 21, 2019
Last NPPES UpdateOctober 14, 20222 updates tracked since enumeration
NPPES CertifiedOctober 14, 2022
✔ NPI 1699249839 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in VA · 0704014248
Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X · License 0710103585 (VA)
8601 ROSE MALLOW DR APT 415, Manassas, VA 20109
Open in Google Maps ↗

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

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

PECOS PAC ID4981172020
PECOS Enrollment IDI20260506002752
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 Keira Jackson's NPI number?

The NPI number for Keira Jackson is 1699249839. It was assigned to this individual provider in the NPPES registry on January 21, 2019.

Where is Keira Jackson located?

Keira Jackson practices at 8601 Rose Mallow Dr Apt 415, Manassas, VA 20109. The listed phone number is (757) 232-9100.

What is Keira Jackson's specialty?

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

Is Keira Jackson enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Keira Jackson was last updated on October 14, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.