Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Nicole L. Jackson, CSAC, ICS, LPC-IT

Individual provider Counselor · NPI 1144489261

Nicole L. Jackson, CSAC, ICS, LPC-IT is a Mental Health Counselor in Milwaukee, Wisconsin. Qualified in 2008, 18 years ago. Practices as a sole proprietor and accepts Medicare assignment. Licensed in Wisconsin.

Years since qualifying
18
Licensed in
WI
In the registry since
2008
Specialties on file
4
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Practice location Address checks out

6815 W Capitol Dr Ste 304
Milwaukee, WI 53216-2056
Phone: (414) 604-6488
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Professional Counselor (primary) Taxonomy 101YP2500X · Licence 7520-125 (WI)
Counselor Taxonomy 101Y00000X · Licence 15477-135
Addiction (Substance Use Disorder) Counselor Taxonomy 101YA0400X · Licence 15137-132 (WI)
Mental Health Counselor Taxonomy 101YM0800X · Licence 638-226 (WI)

Record details

NPI number1144489261
Entity typeIndividual (Type 1)
GenderFemale
Credentials CSAC , ICS , LPC-IT
Sole proprietorYes
NPI enumeratedJune 4, 2008
Last updated in NPPESAugust 29, 2025
Certification dateAugust 29, 2025

Medicare enrollment

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

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2008 (18 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Milwaukee