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

Miss. Lena Citirah Jackson, LCAS, LCMHC

Individual provider Mental Health Counselor · NPI 1710107404

Miss. Lena Citirah Jackson, LCAS, LCMHC is a Mental Health Counselor in Fayetteville, North Carolina. Qualified in 2011, 15 years ago. Licensed in North Carolina.

Years since qualifying
15
Licensed in
NC
In the registry since
2007
Specialties on file
2
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Practice location Address checks out

1724 Roxie Ave
Fayetteville, NC 28304-1623
Phone: (910) 778-5900
Fax: (919) 758-9317
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Addiction (Substance Use Disorder) Counselor (primary) Taxonomy 101YA0400X · Licence 2211 (NC)
Mental Health Counselor Taxonomy 101YM0800X · Licence 12462 (NC)

Record details

NPI number1710107404
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCAS , LCMHC
Sole proprietorNo
NPI enumeratedApril 26, 2007
Last updated in NPPESNovember 18, 2025
Certification dateNovember 18, 2025

Medicare enrollment

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

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2011 (15 years in practice)
Accepts Medicare assignment Not indicated

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