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

Illya Jackson

Individual provider Marriage & Family Therapist · NPI 1700269149

Illya Jackson is a Marriage & Family Therapist in Ft Worth, Texas. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2015

Practice location Address checks out

1518 Vaughn Blvd
Ft Worth, TX 76105-2307
Phone: (214) 515-2079
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Marriage & Family Therapist (primary) Taxonomy 106H00000X · Licence IACCP0064 (CA)

Record details

NPI number1700269149
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedJuly 2, 2015
Last updated in NPPESJuly 2, 2015
Mailing address1518 Vaughn Blvd, Ft Worth, TX 76105-2307

Other providers in Ft Worth