CHEMARA JACKSON ED.D. LPC NPI 1265830954

NPI Information

NPI: 1265830954
Provider Name: CHEMARA JACKSON, ED.D., LPC
Classification: Counselor - 101YP2500X
Entity Type: Individual

Specialization: Professional

Address:
4845 LOCHERBY DR
FAIRBURN, GA
ZIP 30213
Phone: (404) 754-2989
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Chemara Jackson, ED.D., LPC is a professional counselor in Fairburn, GA. Chemara Jackson, ED.D., LPC NPI is 1265830954. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

4845 LOCHERBY DR
FAIRBURN, GA
ZIP 30213-385
Phone: (404) 754-2989

The enumeration date for this NPI number is 12/11/2014 and was last updated on 1/23/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YP2500X	Counselor	Professional	LPC008086	GEORGIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	003140046A	MEDICAID	GEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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