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

MS. Mary Theresa Jackson, LPC

Individual provider Mental Health Counselor · NPI 1699121129

MS. Mary Theresa Jackson, LPC is a Mental Health Counselor in Ellabell, Georgia. Qualified in 2016, 10 years ago. Practices as a sole proprietor and works from 2 locations. Licensed in Georgia.

Years since qualifying
10
Licensed in
GA
In the registry since
2016
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

345 Old Cuyler Rd
Ellabell, GA 31308-5858
Phone: (912) 320-3205
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 6605 Abercorn Street, Savannah, GA 31405 — (912) 320-3205

Specialties & licences

Professional Counselor (primary) Taxonomy 101YP2500X · Licence LPC011711 (GA)
Mental Health Counselor Taxonomy 101YM0800X

Record details

NPI number1699121129
Entity typeIndividual (Type 1)
GenderFemale
Credentials LPC
Sole proprietorYes
NPI enumeratedMay 13, 2016
Last updated in NPPESNovember 27, 2023
Certification dateSeptember 11, 2020

Medicare enrollment

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

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Accepts Medicare assignment Not indicated

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