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JEAN PETRILLA JACKSON MA, LPC
NPI 1710048830
Counselor - Professional in Odessa, TX

Active since December 12, 2006
855 CENTRAL DR, ODESSA, TX 79761(432) 580-7250(432) 582-2020 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Jean Petrilla Jackson Ma, Lpc NPPES

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

JEAN PETRILLA JACKSON MA, LPC (NPI 1710048830) is an individual professional provider in Odessa, Texas, licensed in Texas (14966) and active in the NPI registry since December 2006.

NPPES Registry Identity

NPI1710048830
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameJEAN PETRILLA JACKSONCredential: MA, LPC
Location Address855 CENTRAL DROdessa, TX 79761-4200
Mailing Address1200 W 10th StOdessa, TX 79763-3546 · (432) 580-7250 · Fax (432) 582-2020
Phone(432) 580-7250
Fax(432) 582-2020
Sole ProprietorYes
Enumeration DateDecember 12, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1710048830 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 TX · 14966
855 CENTRAL DR, Odessa, TX 79761
Open in Google Maps ↗

Other Identifiers 3

Other1296590Cigna
Other5212693Aetna
Other3710LCTX · Bluecross Blueshield

Other Providers at the Same Location NPPES 5

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

SENTRY MEDICAL CORPORATION
Physiological Laboratory
855 CENTRAL DR, SUITE 15
ODESSA, TX 79761
Ector County (432) 331-1492
RACHEL HURFORD
Counselor (Professional)
855 CENTRAL DR
ODESSA, TX 79761
Ector County (432) 614-5720
MISTY LOCKNANE LCDC
Counselor (Addiction (Substance Use Disorder))
855 CENTRAL DR, SUITE 2
ODESSA, TX 79761
Ector County (432) 614-5720
ATEC GROUP, LLC
Hearing Instrument Specialist
855 CENTRAL DR, SUITE 16
ODESSA, TX 79761
Ector County (432) 296-6617
MYRNA RUSSELL LCDC
Counselor (Addiction (Substance Use Disorder))
855 CENTRAL DR, SUITE 15
ODESSA, TX 79761
Ector County (432) 557-5759

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 Jean Jackson's NPI number?

The NPI number for Jean Jackson is 1710048830. It was assigned to this individual provider in the NPPES registry on December 12, 2006.

Where is Jean Jackson located?

Jean Jackson practices at 855 Central Dr, Odessa, TX 79761. The listed phone number is (432) 580-7250.

What is Jean Jackson'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 Jean Jackson was last updated on July 8, 2007. NPI Profile syncs with the weekly NPPES data releases published by CMS.