Individual
SAMANTHA LACHELLE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCPC
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LC11555
MD
101YP2500X
Professional Counselor
LGP9650
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
210292700
—
MD
Enumeration date
07/03/2019
Last updated
06/05/2023
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up