Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1184761561 Individual Practitioner Female Practitioner

Dewanda B. Jackson , LPC, CPCS, EAU-C

Counselor - Professional • Decatur, GA

✓ Accepts Medicare Assignment Telehealth Available

Professional Overview & Biography Verified Profile Summary

Dewanda Jackson, LPC, CPCS, EAU-C is a certified Counselor - Professional practicing in Decatur, GA. With approximately 34 years of clinical experience since completing medical education in 1992, Dewanda Jackson delivers high-quality medical care to the local community at 4319 COVINGTON HWY STE 110.

Dewanda Jackson is affiliated with Marvelous Light Consultants and accepts Medicare assignment . Telehealth and virtual consultation options are available for eligible patients.

Practice Location & Contact Primary Location

Practice Address

4319 Covington Hwy Ste 110

Decatur, GA 300351206

Telephone 4042860054
Fax 4042860064
Associated Practice Facility / Clinic
🏢 Marvelous Light Consultants Facility NPI 1922145325

Medicare Profile & Education

Medical School

Other

Graduation Year

1992

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

Telehealth Services Available

Specialty Benchmarks & Practice Insights

Comparative analytics for Counselor - Professional in Decatur, GA

Senior Veteran Specialist (>20 Yrs)
Practitioner Clinical Experience
34 Yrs +18.9 yrs vs City Avg
City Avg: 15.1 Yrs
State Avg: 15.6 Yrs
Regional Practice Density
243 Specialists

Practicing in Decatur, GA (6655 Statewide)

Telehealth Adoption Rate
4.1% Regional Adoption

✓ Offers Virtual Consultations

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Jackson (34 Years) 34 Yrs
Decatur Specialty Average (15.1 Years) 15.1 Yrs

Medical Specialties & State Licenses

CMS Verified: 2021-06-23
Counselor - Professional Primary Specialty

NUCC Taxonomy Code: 101YP2500X

State License GA LPC002390

Definition to come...

Additional State Medicaid & Healthcare Payer Identifiers

Commercial Insurance / Payer ID Professional Counselor
LPC002390 (GA)

Hospital & Practice Group Affiliations

Marvelous Light Consultants

5322 Snapfinger Park Dr, Decatur, GA 300354040

Phone: 4042860054

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

2 Associated Practitioners
Eleanor Mckenzie , LPC

Counselor - Professional

NPI 1114292612

Licensed Professional Counselor

Jacquelyn Ramsey , MSW002670

Community/Behavioral Health

NPI 1255512521

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

9 Historical Events
📍
Updated Practice Location June 23, 2021

Registered at 4319 COVINGTON HWY STE 110, DECATUR, GA 300351206 (Tel: 4042860054)

📍
Updated Business Mailing Address June 23, 2021

Registered at PO BOX 1501, LITHONIA, GA 300581007 (Tel: 4042860054)

👤
Provider Name / Credentials Updated June 23, 2021

Recorded as DEWANDA JACKSON, LPC, CPCS, EAU-C

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

📍
Updated Practice Location July 08, 2007

Registered at 4484 COVINGTON HWY, SUITE 100A, DECATUR, GA 300351203 (Tel: 4042860054)

📍
Updated Business Mailing Address July 08, 2007

Registered at 4484 COVINGTON HWY, SUITE 100A, DECATUR, GA 300351203 (Tel: 4042860054)

👤
Provider Name / Credentials Updated July 08, 2007

Recorded as DEWANDA JACKSOON, LPC

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Counselor (License #LPC002390 in GA)

🟢
Initial NPI Registration & Enumeration February 01, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1184761561
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: February 01, 2007
Last Update: June 23, 2021
Sole Proprietor: No

Mailing Address

Po Box 1501

Lithonia, GA 300581007

Phone: 4042860054

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.