Jackson Lake, LAC
NPI 1720763717 · Mental Health Counselor · Little Rock, AR
Jackson Lake, LAC is a Mental Health Counselor provider in Little Rock, AR (NPI 1720763717).
Provider details
- NPI number
- 1720763717
- Entity type
- Individual
- Primary specialty
- Mental Health CounselorBehavioral Health & Social Service Providers
- Credential
- LAC
- Sex
- Male
- Sole proprietor
- Yes
- License
- A2305013 (AR)
Specialties & taxonomies
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
3 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
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
Registry dates
- Enumerated
- 2023-06-19
- Last updated
- 2023-06-19
- Certified
- 2023-06-19
Frequently asked questions
- What is Jackson Lake's NPI number?
- Jackson Lake's National Provider Identifier (NPI) is 1720763717, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Jackson Lake's specialty?
- Jackson Lake is listed in the NPPES registry with a primary specialty of Mental Health Counselor (Behavioral Health & Social Service Providers).
- Where is Jackson Lake located?
- Jackson Lake's practice location on file with NPPES is 10020 N Rodney Parham Rd Ste G, Little Rock, AR 72227-5588.
- What is Jackson Lake's phone number?
- The practice phone number listed in the NPPES registry for Jackson Lake is (501) 831-4314.
- Is Jackson Lake's NPI active?
- Yes — Jackson Lake's NPI (1720763717) is active in the NPPES registry as of the last update on 2023-06-19.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.