Jackson Psychotherapy, Llc
LBN: Jackson Psychotherapy, Llc
Jackson Psychotherapy, Llc is an health care organization with primary practice located at 901 Kentucky St Ste 306 , Lawrence KS 66044-2858. The organization recently has only one registered license in Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center), which is considered as the primary health care specialty.
Jackson Psychotherapy, Llc can be contacted via phone (816) 377-7398, or through Jackson, Reginald C. via phone (816) 377-7398.
Contact Information
Primary practice address
901 Kentucky St Ste 306
Lawrence KS 66044-2858
Phone: (816) 377-7398
Fax: (816) 873-1364
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center) | 261QM0801X | 4352 | Kansas |
Profile Details
| NPI number | 1578064861 |
|---|---|
| LBN Legal business name | Jackson Psychotherapy, Llc |
| DBA Doing business as | |
| Authorized official | Jackson, Reginald C. LSCSW, LCSW |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Feb 22nd, 2018 |
| Last updated | Feb 22nd, 2018 - about 7 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1578064861 | NPPES |
| Missouri | MEDICAID | 2015021883 | |
| Missouri | MEDICAID | 4352 | |
| Missouri | Other | 2015021883 | |
| Missouri | Other | 4352 |
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