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ANTOINETTE ROSA JACKSON (AZIZ) LPC
NPI 1700439171
Counselor - Professional in Philadelphia, PA

Active since July 24, 2019
6122 RIDGE AVE, PHILADELPHIA, PA 19128(215) 487-1330 Get Directions Write a Review

NPPES record last updated: July 24, 2019. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Antoinette Rosa Jackson (aziz) Lpc NPPES

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

ANTOINETTE ROSA JACKSON (AZIZ) LPC (NPI 1700439171) is an individual professional provider in Philadelphia, Pennsylvania, licensed in Pennsylvania (PC009302) and active in the NPI registry since July 2019.

NPPES Registry Identity

NPI1700439171
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameANTOINETTE ROSA JACKSON (AZIZ)Credential: LPC
Location Address6122 RIDGE AVEPhiladelphia, PA 19128-1603
Mailing Address6014 Catharine St # BPhiladelphia, PA 19143-2306 · (215) 432-8608
Phone(215) 487-1330
Sole ProprietorYes
Enumeration DateJuly 24, 2019
✔ NPI 1700439171 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in PA · PC009302
6122 RIDGE AVE, Philadelphia, PA 19128
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

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.

MRS. JULEY ANNE MOBERG M.S. L.P.C.
Counselor (Professional)
6122 RIDGE AVE
PHILADELPHIA, PA 19128
Philadelphia County (215) 487-1330
ANDREA LOUISE BRANNEN M.A.
Counselor (Mental Health)
6122 RIDGE AVE
PHILADELPHIA, PA 19128
Philadelphia County (215) 487-1330
KIRSTEN KNOBLAUCH LPC
Counselor (Professional)
6122 RIDGE AVE
PHILADELPHIA, PA 19128
Philadelphia County (215) 487-1330
KAITLYN DEVEREAUX BCBA, LBS
Behavior Analyst
6122 RIDGE AVE
PHILADELPHIA, PA 19128
Philadelphia County (215) 487-1330
DR. RINA VENTURA MASCHLER PSY.D.
Psychologist (Clinical)
6122 RIDGE AVE
PHILADELPHIA, PA 19128
Philadelphia County (215) 487-1330
SEBASTIAN RIMEHAUG LPC
Counselor (Professional)
6122 RIDGE AVE
PHILADELPHIA, PA 19128
Philadelphia County (215) 487-1330
MS. LISA SUZANNE HIXENBAUGH MA, ATR-BC, LPC
Counselor
6122 RIDGE AVE
PHILADELPHIA, PA 19128
Philadelphia County (215) 487-1330
BRIANNA TALIA WILLIAMS
Counselor (Mental Health)
6122 RIDGE AVE
PHILADELPHIA, PA 19128
Philadelphia County (215) 508-6700

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 Antoinette Jackson (aziz)'s NPI number?

The NPI number for Antoinette Jackson (aziz) is 1700439171. It was assigned to this individual provider in the NPPES registry on July 24, 2019.

Where is Antoinette Jackson (aziz) located?

Antoinette Jackson (aziz) practices at 6122 Ridge Ave, Philadelphia, PA 19128. The listed phone number is (215) 487-1330.

What is Antoinette Jackson (aziz)'s specialty?

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

When was this NPI record last updated?

The NPPES record for Antoinette Jackson (aziz) was last updated on July 24, 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.