MRS. SANDRA JACKSON LMHC NPI 1356330765

NPI Information

  • NPI: 1356330765
  • Provider Name: MRS. SANDRA JACKSON, LMHC
  • Classification: Counselor - 101YM0800X
  • Specialization: Mental Health
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 1880 SAN SEBASTIAN VW STE 4201
    ST AUGUSTINE, FL
    ZIP 32084
  • Phone: (800) 539-4228

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NPI Details

MRS. Sandra Jackson, LMHC is a mental health counselor in St Augustine, FL. MRS. Sandra Jackson, LMHC NPI is 1356330765. 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:

1880 SAN SEBASTIAN VW STE 4201
ST AUGUSTINE, FL
ZIP 32084-684
Phone: (800) 539-4228

The NPI 1356330765 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment.

The enumeration date for this NPI number is 10/18/2005 and was last updated on 10/31/2025.

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
1101YM0800XCounselorMental HealthMH8391FLORIDAYes
2101Y00000XCounselorMH8391FLORIDANo

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
1767122900MEDICAIDFLORIDA
2Z089AOTHERFLORIDABCBS

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

NPI Synchronization or Removal

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