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

Mary Jackson, LPC-22257

Individual provider Professional Counselor · NPI 1881374684

Mary Jackson, LPC-22257 is an Undefined Non-Physician Type (Specify) in Payson, Arizona. Qualified in 2015, 11 years ago. Practices with Southwest Behavioral Health Services Inc, a 48-clinician group. Licensed in Arizona.

Years since qualifying
11
Licensed in
AZ
In the registry since
2023

Practice location Address checks out

404 W Aero Dr
Payson, AZ 85541-5407
Phone: (928) 474-3303
Show map & directions

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

Specialties & licences

Professional Counselor (primary) Taxonomy 101YP2500X · Licence LPC-22257 (AZ)

Record details

NPI number1881374684
Entity typeIndividual (Type 1)
GenderFemale
Credentials LPC-22257
Sole proprietorNo
NPI enumeratedJuly 18, 2023
Last updated in NPPESJuly 18, 2023
Certification dateJuly 18, 2023

Medicare enrollment

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

Medicare specialtyUNDEFINED NON-PHYSICIAN TYPE (SPECIFY)
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Group practice Southwest Behavioral Health Services Inc — 48 clinicians
Accepts Medicare assignment Not indicated

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