Jackson T Douglas , LPC
Counselor - Professional β’ Springfield, MO
1300 E Bradford Pkwy
Springfield, MO 658044264
This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.
Practice Location & Contact Primary Location
1300 E Bradford Pkwy
Springfield, MO 658044264
Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.
NPPES lists 1 additional practice-address record in Colorado Springs, CO. See the list
Source: CMS NPPES NPI Registry, practice location records; release date unavailable.
Listings do not confirm current availability, employment or a shared ownership network.
What Public CMS Data Show
Counselor - Professional: NPPES taxonomy is a reported classification, not proof of board certification.
NPI first issued
2012
The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.
What this does not show: NPI first issued
NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.
Source: CMS NPPES NPI Registry.
Medicare assignment not listed
CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.
Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.
Source: CMS Doctors and Clinicians; Medicare.gov, βDoes your provider accept Medicare as full payment?β
No telehealth indicator
CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.
Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.
Compared with the same specialty in Springfield and Missouri
647 active clinicians are listed under Counselor - Professional with a practice address in Springfield, MO (5,803 in Missouri).
Addresses are self-reported to NPPES and may be out of date.
Telehealth indicator in Springfield
2.3% of these 647 clinicians have the CMS telehealth indicator.
9.4% of these 647 clinicians are listed by CMS as accepting Medicare assignment.
Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.
Text: T-MedInfo Β· Report an error.
Specialties & License Numbers Reported to NPPES
Self-certified to NPPES: 2022-08-22NUCC Taxonomy Code: 101YP2500X
NUCC Taxonomy Code: 101Y00000X
A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.
Secondary Practice Locations
875 W Moreno Ave
Colorado Springs, CO 809051731
Phone: 7195726100
Clinicians Sharing This Practice Address or Phone
Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.
Social Worker - Clinical
Master of Social Work, Licensed Clinical Social Worker
Psychologist - Clinical
Doctor of Psychology (Psy.D.), Licensed Psychologist
Psychiatry & Neurology - Psychiatry
Doctor of Medicine (M.D.)
Psychiatry & Neurology - Psychiatry
Doctor of Medicine (M.D.)
Nurse Practitioner - Psychiatric/Mental Health
Master of Science in Nursing, FPMHNP
Psychiatry & Neurology - Psychiatry
Doctor of Medicine (M.D.)
Career & Practice History Timeline
Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status
Registered at 1300 E BRADFORD PKWY, SPRINGFIELD, MO 658044264 (Tel: 4177615000)
Registered at 1300 E BRADFORD PKWY, SPRINGFIELD, MO 658044264 (Tel: 4177615000)
Recorded as JACKSON DOUGLAS, LPC
NPI status registered as active in NPPES database
Registered at 875 W MORENO AVE, COLORADO SPRINGS, CO 809051731 (Tel: 7195726100)
Registered at 220 RUSKIN DR, COLORADO SPRINGS, CO 809102522 (Tel: 7195726100)
Recorded as JACKSON DOUGLAS, MA
Counselor
First registered as active Individual Practitioner in NPPES Database.
NPI Administrative Meta
Other Counselor - Professionals in Springfield
Healthcare providers in SpringfieldMailing Address
1300 E Bradford Pkwy
Springfield, MO 658044264
Phone: 4177615000