Samantha Rae Jackson, LPC
NPI 1245607357ActiveIndividual· Counselor· Chardon, OH
Counselor (LPC) with Ravenwood Mental Health Center, practicing in Chardon, Ohio. Enrolled in Medicare as practitioner - mental health counselor.
Overview
| NPI | 1245607357 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | LPC |
| Sole proprietor | No |
| NPI issued | Aug 24, 2015 |
| Last updated in NPPES | Aug 24, 2015 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Counselor Primary | 101Y00000X | C.1100378 | OH |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Mental Health Counselor (OH) |
|---|
Education and affiliations
| Graduation year | 2012 |
|---|---|
| Medicare specialty | Mental Health Counselor |
Medical group
- Ravenwood Mental Health CenterChardon, OH · 56 clinicians
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