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NPI Code Detail

MEDICARE: ASHLEY N. JACKSON MA, LMHC

MEDICARE: ASHLEY N. JACKSON MA, LMHC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor39003685AIN

General Provider Information

NPI Number : 1275874851
Entity Type Code : Individual
Provider Name (Legal Business Name) : ASHLEY N. JACKSON MA, LMHC
Provider Business Mailing Address
First Line : PO BOX 637764
Second Line :
City : CINCINNATI
State : OH
Zip : 45263-7764
Country : US
Telephone Number : 317-880-3939
Fax Number : 317-880-0343
Provider Business Practice Location Address
First Line : 720 ESKENAZI AVE
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46202-5187
Country : US
Telephone Number : 317-880-7666
Fax Number : 317-880-0448
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/07/2013
Last Update Date : 03/24/2026

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