JENNIFER R JACKSON LPC
NPI 1811377161
Counselor - Mental Health in Mesa, AZ

Q: What is Jennifer Jackson's NPI number?

The NPI number for Jennifer Jackson is 1811377161. It was assigned to this individual provider in the NPPES registry on June 2, 2015.

Q: What is Jennifer 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 Jennifer Jackson was last updated on December 5, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since June 02, 2015PECOS Enrolled

2120 W GUADALUPE RD STE 6, MESA, AZ 85202(602) 230-7373(480) 629-8577 Get Directions Write a Review

NPPES record last updated: December 5, 2025. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Jennifer R Jackson Lpc NPPES

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

JENNIFER R JACKSON LPC (NPI 1811377161) is an individual mental health provider in Mesa, Arizona, licensed in Arizona (LPC-23931) and active in the NPI registry since June 2015. She is enrolled in Medicare PECOS and maintains a secondary practice location in Phoenix.

NPPES Registry Identity

NPI1811377161

Entity TypeIndividualFemale

Primary Taxonomy101YM0800X

Provider Legal NameJENNIFER R JACKSONCredential: LPC

Location Address2120 W GUADALUPE RD STE 6Mesa, AZ 85202-7366

Mailing Address3101 N Central Ave Ste 550Phoenix, AZ 85012-2635 · (602) 230-7373 · Fax (602) 682-7455

Phone(602) 230-7373

Fax(480) 629-8577

Sole ProprietorNo

Enumeration DateJune 2, 2015

Last NPPES UpdateDecember 5, 2025

NPPES CertifiedDecember 5, 2025

✔ NPI 1811377161 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 AZ · LPC-23931

2120 W GUADALUPE RD STE 6, Mesa, AZ 85202

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Secondary Practice Location 1

Location 12102 W Bethany Home RdPhoenix, AZ 85015-1935 · Phone (602) 774-4745

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross Blue Shield of Arizona, Oscar Health Plan, Inc., UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jennifer R Jackson Lpc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 10

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

MOLLIE GLOVINSKY DNP, PMHNP-BC

Nurse Practitioner (Psychiatric/Mental Health)