DR. TANAYA MOON JACKSON LPC NPI 1659558807

NPI Information

  • NPI: 1659558807
  • Provider Name: DR. TANAYA MOON JACKSON, LPC
  • Classification: Counselor - 101YP2500X
  • Specialization: Professional
  • Entity Type: Individual
  • Address: 5915 THIRTY THREE MILE RD
    CASPER, WY
    ZIP 82604
  • Phone: (307) 760-6340

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NPI Details

DR. Tanaya Moon Jackson, LPC is a professional counselor in Casper, WY. DR. Tanaya Moon Jackson, LPC NPI is 1659558807. 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:

5915 THIRTY THREE MILE RD
CASPER, WY
ZIP 82604-585
Phone: (307) 760-6340

The enumeration date for this NPI number is 1/29/2008 and was last updated on 9/25/2025.

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
1101YP2500XCounselorProfessionalLPC-1179WYOMINGYes

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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