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

Samantha Lachelle Jackson, LCPC

Individual provider Professional Counselor · NPI 1609438225

Samantha Lachelle Jackson, LCPC is a Mental Health Counselor in Baltimore, Maryland. Qualified in 2016, 10 years ago. Licensed in Maryland.

Years since qualifying
10
Licensed in
MD
In the registry since
2019
Specialties on file
2
What do these letters mean?
LCPC — Licensed Clinical Professional Counselor
A licensed clinical counsellor.

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Practice location Address checks out

4317 Harford Rd
Baltimore, MD 21214-3118
Phone: (443) 708-7510
Fax: (410) 275-0992
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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 LC11555 (MD)
Professional Counselor Taxonomy 101YP2500X · Licence LGP9650 (MD)

Record details

NPI number1609438225
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCPC
Sole proprietorNo
NPI enumeratedJuly 3, 2019
Last updated in NPPESJune 5, 2023
Certification dateJune 5, 2023

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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