HEATHER JACKSON (LPC) – Professional Counselor, NPI 1104549336

HEATHER JACKSON (LPC) is a healthcare provider. based in Lawrence, Kansas. specializing in MENTAL HEALTH COUNSELOR. They hold the professional credentials LPC. They hold a License No. 04163 (KS). The NPI Number for HEATHER JACKSON (LPC) is 1104549336

Main info

Female
4 Years Of Experience
Name
HEATHER JACKSON (LPC)
NPI
1104549336
Phone
(785) 393-6167
Address
1045 E 23RD ST
Enumeration Date
22 September 2022
Last Update Date
22 September 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7853936167
Graduation Year
2022 (4 years ago)
PAC ID
2365986742
Group Practice PAC ID
9739310343
Professional Enrollment ID
I20240626002489
Address ID
KS660465003LA1045XSTXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience30
Completeness75
Years active:3State licenses:1Digital endpointsOther names

387 MENTAL HEALTH COUNSELOR in KS

Provider Addresses for HEATHER JACKSON (LPC)

  • 1045 E 23RD ST

    LAWRENCE, KS 660465003

    Phone: (785) 393-6167

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-06-26

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240626002489IMental Health CounselorKSTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 66046)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9739310343View full group profile
NameSpecialtyState
Nurse PractitionerKS
Nurse PractitionerKS
Nurse PractitionerKS
Mental Health CounselorKS
Neuropsychiatry, NeurologyMO
Marriage And Family TherapistKS
Nurse PractitionerKS
Mental Health CounselorCA
Mental Health CounselorKS
P S Y C H I A T R YKS

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Frequently asked questions

What federal number belongs to HEATHER JACKSON (LPC)?
The federal identifier for HEATHER JACKSON (LPC) is NPI 1104549336.
Is HEATHER JACKSON (LPC)'s NPI currently valid?
The extract we use shows HEATHER JACKSON (LPC) as active.
What kind of provider is HEATHER JACKSON (LPC)?
The page reflects Professional Counselor for HEATHER JACKSON (LPC). Clinical services aligned with this taxonomy classification.
What location shows for HEATHER JACKSON (LPC)?
We surface Lawrence, Kansas for HEATHER JACKSON (LPC) based on available NPPES addresses.
What if Lawrence, Kansas seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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