MR. JERRY MICHAEL JACKSON MSW, ACSW
NPI 1699887166
Counselor - Mental Health in Bellevue, WA

Q: What is Jerry Jackson's NPI number?

The NPI number for Jerry Jackson is 1699887166. It was assigned to this individual provider in the NPPES registry on August 31, 2006.

Q: What is Jerry 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 Jerry Jackson was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.

Active since August 31, 2006

11016 NE 2ND PL, BELLEVUE, WA 98004(425) 455-0348(206) 367-0547 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Mr. Jerry Michael Jackson Msw, Acsw NPPES

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

MR. JERRY MICHAEL JACKSON MSW, ACSW (NPI 1699887166) is an individual mental health provider in Bellevue, Washington, licensed in Washington (LW00004286) and active in the NPI registry since August 2006.

NPPES Registry Identity

NPI1699887166

Entity TypeIndividualMale

Primary Taxonomy101YM0800X

Provider Legal NameMR. JERRY MICHAEL JACKSONCredential: MSW, ACSW

Location Address11016 NE 2ND PLBellevue, WA 98004-5830

Mailing Address3723 Ne 150th StLake Forest Park, WA 98155-7828 · (206) 367-3351 · Fax (206) 367-0547

Phone(425) 455-0348

Fax(206) 367-0547

Sole ProprietorYes

Enumeration DateAugust 31, 2006

Last NPPES UpdateJuly 8, 2007

✔ NPI 1699887166 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 WA · LW00004286

11016 NE 2ND PL, Bellevue, WA 98004

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Other Identifiers 1

OtherLW00004286WA · Licensed Social Worker

Other Providers at the Same Location NPPES 2

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

DR. BARBARA RYAN PHD, LMHC

Counselor (Mental Health)

11016 NE 2ND PL
BELLEVUE, WA 98004

King County (425) 458-4770

SUZANNE S BLINSTRUB LMHC

Registered Nurse (Addiction (Substance Use Disorder))

11016 NE 2ND PL
BELLEVUE, WA 98004

King County (425) 646-7892

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 Jerry Jackson's NPI number?

The NPI number for Jerry Jackson is 1699887166. It was assigned to this individual provider in the NPPES registry on August 31, 2006.

Where is Jerry Jackson located?

Jerry Jackson practices at 11016 NE 2nd Pl, Bellevue, WA 98004. The listed phone number is (425) 455-0348.

What is Jerry Jackson's specialty?

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

When was this NPI record last updated?

The NPPES record for Jerry Jackson was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.