Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Deirdre Renee Jackson, PHDLCMHCSLPCNCC

Individual provider Mental Health Counselor · NPI 1215343009

Dr. Deirdre Renee Jackson, PHDLCMHCSLPCNCC is a Mental Health Counselor in Clarksville, Tennessee. Qualified in 1996, 30 years ago. Practices with Brightside Medical PC, a 280-clinician group and accepts Medicare assignment. Licensed in Louisiana, North Carolina, Tennessee and Texas.

Years since qualifying
30
Licensed in
LA, NC, TN, TX
In the registry since
2014
Specialties on file
4
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Practice location Address checks out

1059 Spicer Dr
Clarksville, TN 37042-2120
Phone: (615) 473-5152
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Professional Counselor (primary) Taxonomy 101YP2500X · Licence 5911 (LA)
Mental Health Counselor Taxonomy 101YM0800X · Licence S12958 (NC)
Professional Counselor Taxonomy 101YP2500X · Licence 1744 (TN)
Professional Counselor Taxonomy 101YP2500X · Licence 77544 (TX)

Record details

NPI number1215343009
Entity typeIndividual (Type 1)
GenderFemale
Credentials PHDLCMHCSLPCNCC
Sole proprietorYes
NPI enumeratedJuly 1, 2014
Last updated in NPPESJuly 20, 2022
Certification dateJuly 20, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 1996 (30 years in practice)
Group practice Brightside Medical Pc — 280 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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