| Allison Charee Jackson, LPCC | |
|
1448 Diederich Blvd, Russell, KY 41169-1719 | |
| (606) 834-0020 | |
| (606) 834-0049 |
| Full Name | Allison Charee Jackson |
|---|---|
| Gender | Female |
| Speciality | Counselor - Professional |
| Location | 1448 Diederich Blvd, Russell, Kentucky |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669930517 | NPI | - | NPPES |
| 7100587020 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 104618 (Kentucky) | Primary |
| Entity Name | Lighthouse Professional Counseling Services Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1003218546 PECOS PAC ID: 4082938477 Enrollment ID: O20150112002286 |
| Entity Name | Extended Care Specialists, Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1134146079 PECOS PAC ID: 2466407713 Enrollment ID: O20190703001141 |
| Mailing Address | Practice Location Address |
|---|---|
| Allison Charee Jackson, LPCC 1448 Diederich Blvd, Russell, KY 41169-1719 Ph: (606) 834-0020 | Allison Charee Jackson, LPCC 1448 Diederich Blvd, Russell, KY 41169-1719 Ph: (606) 834-0020 |
Debora K Reeves, LCSW, LCADC Counselor Medicare: Accepting Medicare Assignments Practice Location: 1448 Diederich Blvd, Russell, KY 41169 Phone: 606-834-0020 Fax: 606-834-0049 | |
Courtney Joyce, LPCA Counselor Medicare: Not Enrolled in Medicare Practice Location: 1448 Diederich Blvd, Russell, KY 41169 Phone: 606-834-0020 Fax: 606-834-0049 | |
Tiffany Blanton, LPCC, NCC Counselor Medicare: Medicare Enrolled Practice Location: 1448 Diederich Boulveard, Russell, KY 41169 Phone: 606-834-0020 Fax: 606-834-0049 |