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MISS LENA CITIRAH JACKSON LCAS, LCMHC
NPI 1710107404
Counselor - Addiction (Substance Use Disorder) in Fayetteville, NC

Active since April 26, 2007PECOS Enrolled
1724 ROXIE AVE, FAYETTEVILLE, NC 28304(910) 778-5900(919) 758-9317 Get Directions Write a Review

NPPES record last updated: November 18, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Miss Lena Citirah Jackson Lcas, Lcmhc NPPES

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

MISS LENA CITIRAH JACKSON LCAS, LCMHC (NPI 1710107404) is an individual addiction (substance use disorder) provider in Fayetteville, North Carolina, licensed in North Carolina (2211) and active in the NPI registry since April 2007. She is enrolled in Medicare PECOS and is a graduate of Other (2011).

NPPES Registry Identity

NPI1710107404
Entity TypeIndividualFemale
Primary Taxonomy101YA0400X
Provider Legal NameMISS LENA CITIRAH JACKSONCredential: LCAS, LCMHC
Location Address1724 ROXIE AVEFayetteville, NC 28304-1623
Mailing Address11361 N 99th Ave Ste 402Peoria, AZ 85345-5459 · (602) 650-1212
Phone(910) 778-5900
Fax(919) 758-9317
Sole ProprietorNo
Medical School CMSOtherGraduated 2011
Enumeration DateApril 26, 2007
Last NPPES UpdateNovember 18, 2025
NPPES CertifiedNovember 18, 2025
✔ NPI 1710107404 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
License✔ Licensed in NC · 2211
Also ListedCounselor · Mental HealthTaxonomy 101YM0800X · License 12462 (NC)
1724 ROXIE AVE, Fayetteville, NC 28304
Open in Google Maps ↗

Other Identifiers 1

Other18291NC · Bcbs

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Miss Lena Citirah Jackson Lcas, Lcmhc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID1658858840
PECOS Enrollment IDI20260120000698
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.

Other Providers at the Same Location NPPES 18

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

LEON KENTRELLE WILLIAMS LCSWA
Social Worker (Clinical)
1724 ROXIE AVE
FAYETTEVILLE, NC 28304
Cumberland County (919) 758-9317
LA TONYA FRAZIER-MOORE RN
Registered Nurse
1724 ROXIE AVE
FAYETTEVILLE, NC 28304
Cumberland County (919) 758-9317
DIANA WILMA AVILA LCAS
Counselor (Addiction (Substance Use Disorder))
1724 ROXIE AVE
FAYETTEVILLE, NC 28304
Cumberland County (910) 615-3333
DR. AARON AVRUM BRODSKY PHD
Psychologist
1724 ROXIE AVE
FAYETTEVILLE, NC 28304
Cumberland County (910) 615-3333
MR. MICHAEL CHRISTOPHER BAUSH
Counselor
1724 ROXIE AVE
FAYETTEVILLE, NC 28304
Cumberland County (910) 222-6825
MS. ORETHA HARRIS LPC
Counselor (Professional)
1724 ROXIE AVE
FAYETTEVILLE, NC 28304
Cumberland County (910) 615-3333
NAIOMI M MARSHALL LCMHC
Counselor (Mental Health)
1724 ROXIE AVE
FAYETTEVILLE, NC 28304
Cumberland County (910) 778-5900
IRIS SONJA PALIN LCSWA
Social Worker
1724 ROXIE AVE
FAYETTEVILLE, NC 28304
Cumberland County (910) 778-5900

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 Lena Jackson's NPI number?

The NPI number for Lena Jackson is 1710107404. It was assigned to this individual provider in the NPPES registry on April 26, 2007.

Where is Lena Jackson located?

Lena Jackson practices at 1724 Roxie Ave, Fayetteville, NC 28304. The listed phone number is (910) 778-5900.

What is Lena Jackson's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

Is Lena Jackson enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Lena Jackson was last updated on November 18, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months 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.