Connie Jackson, is a
Counselor - Professional based in Kingsland, Texas. Connie Jackson is licensed to practice in Texas (license number 74377) and her current practice location is
1410 Ranch Road 2900 Ste 303, Kingsland, Texas. She can be reached at her office (for appointments etc.) via phone at
(830) 499-3744.
NPI number for Connie Jackson is 1265973812 and her current mailing address is 1203 Ford St, Llano, Texas. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1265973812.
Healthcare Provider's Profile
Full Name | Connie Jackson |
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Gender | Female |
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Speciality | Counselor - Professional |
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Location | 1410 Ranch Road 2900 Ste 303, Kingsland, Texas |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1265973812
- Provider Enumeration Date: 03/15/2017
- Last Update Date: 10/02/2019
Medical Identifiers
Medical identifiers for Connie Jackson such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1265973812 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101YP2500X | Counselor - Professional | 74377 (Texas) | Primary |
101YA0400X | Counselor - Addiction (substance Use Disorder) | 13344 (Texas) | Secondary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Connie Jackson is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Connie Jackson, 1203 Ford St, Llano, TX 78643-2611 Ph: () - | Connie Jackson, 1410 Ranch Road 2900 Ste 303, Kingsland, TX 78639-5853 Ph: (830) 499-3744 |
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