Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Irene Dormenie Jackson, LCMHC, LCAS-A

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1053927723

Irene Dormenie Jackson, LCMHC, LCAS-A is a Mental Health Counselor in Durham, North Carolina. Qualified in 2018, 8 years ago. Practices with Integrative Wellness Solutions PLLC, a 139-clinician group, accepts Medicare assignment and offers telehealth. Licensed in North Carolina.

Years since qualifying
8
Licensed in
NC
In the registry since
2020
Specialties on file
2
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Practice location Address checks out

904 Woodgreen Dr
Durham, NC 27704-6034
Phone: (919) 641-8358
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X · Licence 16165 (NC)
Addiction (Substance Use Disorder) Counselor Taxonomy 101YA0400X · Licence LCAS-26084 (NC)

Record details

NPI number1053927723
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCMHC , LCAS-A
Sole proprietorYes
NPI enumeratedSeptember 18, 2020
Last updated in NPPESOctober 24, 2024
Certification dateOctober 24, 2024

Medicare enrollment

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

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice Integrative Wellness Solutions Pllc — 139 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in Durham