LARISSA JACKSON MS NPI 1073230736

NPI Information

  • NPI: 1073230736
  • Provider Name: LARISSA JACKSON, MS
  • Classification: Counselor - 101YP2500X
  • Specialization: Professional
  • Entity Type: Individual
  • Address: 1720 LEXINGTON RD STE A
    ATHENS, GA
    ZIP 30605
  • Phone: (706) 543-3522

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NPI Details

Larissa Jackson, MS is a professional counselor in Athens, GA. Larissa Jackson, MS NPI is 1073230736. 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:

1720 LEXINGTON RD STE A
ATHENS, GA
ZIP 30605-330
Phone: (706) 543-3522
Fax: (706) 543-3523

The enumeration date for this NPI number is 10/24/2022 and was last updated on 10/24/2022.

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
1101YP2500XCounselorProfessionalLPC009037GEORGIAYes

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: 11/21/2025

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