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KIMBERLY JACKSON
NPI 1962858050
Counselor in Tallulah, LA

Active since May 09, 2016
1705 FELICIA AVE, TALLULAH, LA 71282(318) 574-1232 Get Directions Write a Review

NPPES record last updated: October 29, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 1, 2024, May 24, 2018, May 9, 2016 (3 updates tracked since 2016).

About Kimberly Jackson NPPES

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

KIMBERLY JACKSON (NPI 1962858050) is an individual counselor in Tallulah, Louisiana, licensed in Louisiana (10088) and active in the NPI registry since May 2016. She maintains a secondary practice location in Lake Providence.

NPPES Registry Identity

NPI1962858050
Entity TypeIndividualFemale
Primary Taxonomy101Y00000X
Provider Legal NameKIMBERLY JACKSON
Location Address1705 FELICIA AVETallulah, LA 71282
Mailing Address1705 Felicia AveTallulah, LA 71282-8203 · (318) 574-1232
Phone(318) 574-1232
Sole ProprietorYes
Enumeration DateMay 9, 2016
Last NPPES UpdateOctober 29, 20253 updates tracked since enumeration
NPPES CertifiedOctober 29, 2025
✔ NPI 1962858050 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyCounselorBehavioral Health & Social Service Providers
Taxonomy Code101Y00000X
License✔ Licensed in LA · 10088
Definition
A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.
Also ListedCounselor · Mental HealthTaxonomy 101YM0800X · License 10088 (LA)
Also ListedCase Manager/Care CoordinatorTaxonomy 171M00000X
1705 FELICIA AVE, Tallulah, LA 71282
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Other Names 1

Former Name (1)Kimberly Jackson

Secondary Practice Location 1

Location 11700 Lake StLake Providence, LA 71254-5208 · Phone (318) 559-0414

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.

MR. CHARLES FOSTER III
Case Manager/Care Coordinator
1705 FELICIA AVE
TALLULAH, LA 71282
Madison Parish (318) 574-1232
LASHINDA SCHENELLE NIX
Case Manager/Care Coordinator
1705 FELICIA AVE
TALLULAH, LA 71282
Madison Parish (318) 719-8196
THELMA HOLLOWAY
Case Manager/Care Coordinator
1705 FELICIA AVE
TALLULAH, LA 71282
Madison Parish (318) 574-1232
JACQUELINE MCMILLAN
Counselor (Mental Health)
1705 FELICIA AVE
TALLULAH, LA 71282
Madison Parish (318) 574-1232
CYNTHIA BRYAN BSW, RSW, LAC
Counselor (Addiction (Substance Use Disorder))
1705 FELICIA AVE
TALLULAH, LA 71282
Madison Parish (318) 574-1232
MR. ARTIS BROWN
Case Manager/Care Coordinator
1705 FELICIA AVE
TALLULAH, LA 71282
Madison Parish (318) 574-1232
BRIANNA L STEVENSON
Counselor (Professional)
1705 FELICIA AVE
TALLULAH, LA 71282
Madison Parish (318) 574-1232
MS. GLENDA HENDON
Counselor (Mental Health)
1705 FELICIA AVE
TALLULAH, LA 71282
Madison Parish (318) 574-1232

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 Kimberly Jackson's NPI number?

The NPI number for Kimberly Jackson is 1962858050. It was assigned to this individual provider in the NPPES registry on May 9, 2016.

Where is Kimberly Jackson located?

Kimberly Jackson practices at 1705 Felicia Ave, Tallulah, LA 71282. The listed phone number is (318) 574-1232.

What is Kimberly Jackson's specialty?

The primary specialty registered for this NPI is Counselor with taxonomy code 101Y00000X.

When was this NPI record last updated?

The NPPES record for Kimberly Jackson was last updated on October 29, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.