MALLORY SUE JACKSON LPC-A CSC NPI 1386513984

NPI Information

  • NPI: 1386513984
  • Provider Name: MALLORY SUE JACKSON, LPC-A, CSC
  • Classification: Counselor - 101YP2500X
  • Specialization: Professional
  • Entity Type: Individual
  • Address: 359 N CYPRESS ST STE 102
    GILMER, TX
    ZIP 75644
  • Phone: (903) 961-6501

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NPI Details

Mallory Sue Jackson, LPC-A, CSC is a professional counselor in Gilmer, TX. Mallory Sue Jackson, LPC-A, CSC NPI is 1386513984. 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:

359 N CYPRESS ST STE 102
GILMER, TX
ZIP 75644-348
Phone: (903) 961-6501

The enumeration date for this NPI number is 11/3/2025 and was last updated on 11/3/2025.

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
1101YP2500XCounselorProfessional98631TEXASYes

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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