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

Individual provider Counselor · NPI 1356695183

Jackson T Douglas, LPC is a Counselor in Springfield, Missouri. Works from 2 locations. Licensed in Missouri.

Licensed in
MO
In the registry since
2012
Specialties on file
2
What do these letters mean?
LPC — Licensed Professional Counselor
A licensed mental health counsellor.

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Practice location Address checks out

1300 E Bradford Pkwy
Springfield, MO 65804-4264
Phone: (417) 761-5000
Fax: (417) 761-5111
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 875 W Moreno Ave, Colorado Springs, CO 80905-1731 — (719) 572-6100

Specialties & licences

Professional Counselor (primary) Taxonomy 101YP2500X · Licence 2014040178 (MO)
Counselor Taxonomy 101Y00000X

Record details

NPI number1356695183
Entity typeIndividual (Type 1)
GenderMale
Credentials LPC
Sole proprietorNo
NPI enumeratedOctober 31, 2012
Last updated in NPPESAugust 22, 2022
Certification dateAugust 22, 2022
Mailing address1300 E Bradford Pkwy, Springfield, MO 65804-4264

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