Jacquelyn Jackson, LMHC
NPI 1003575010 · Mental Health Counselor · Commack, NY
Enrolled with Medicare as Practitioner - Mental Health Counselor · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Provider details
- NPI number
- 1003575010
- Entity type
- Individual
- Primary specialty
- Mental Health CounselorBehavioral Health & Social Service Providers
- Credential
- LMHC
- Sex
- Female
- Sole proprietor
- No
Specialties & taxonomies
Behavioral Health & Social Service Providers
- Mental Health Counselor101YM0800X
Behavioral Health & Social Service Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
4 yrs in NPPES registry
- Profile completeness38% of score
83% of core fields populated
- Practice footprint23% of score
3 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Additional practice locations (2)
- 380 N Broadway Ph EJericho, NY 11753-2198Phone: (631) 533-0315Fax: (855) 752-5170
- 65 Air Park Dr Ste 10Ronkonkoma, NY 11779-7374Phone: (631) 533-0315
Registry dates
- Enumerated
- 2021-12-17
- Last updated
- 2025-03-06
- Certified
- 2025-03-06
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.