Active NPI 1487210399 Individual Practitioner Male Practitioner

Anthony N. Jackson , MA, LPCC, LCADC

Counselor - Professional • Alvaton, KY

Professional Overview & Biography Verified Profile Summary

Anthony Jackson, MA, LPCC, LCADC is a certified Counselor - Professional practicing in Alvaton, KY. With approximately 4 years of clinical experience since completing medical education in 2022, Anthony Jackson delivers high-quality medical care to the local community at 6445 EAST HAVEN WAY.

Anthony Jackson does not directly accept Medicare assignment.

Practice Location & Contact Primary Location

Practice Address

6445 East Haven Way

Alvaton, KY 42122

Telephone 5025096116

Associated Practice Facility / Clinic

🏢 Lake Substance Abuse Solutions Llc Facility NPI 1629900444

Medicare Profile & Education

Medical School

Other

Graduation Year

2022

Medicare Assignment

Not Specified

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Counselor - Professional in Alvaton, KY

Rising Specialist (<5 Yrs)

Practitioner Clinical Experience

4 Yrs -10.0 yrs vs City Avg

City Avg: 14.0 Yrs

State Avg: 13.2 Yrs

Regional Practice Density

13 Specialists

Practicing in Alvaton, KY (2199 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Jackson (4 Years) 4 Yrs

Alvaton Specialty Average (14.0 Years) 14.0 Yrs

Medical Specialties & State Licenses

CMS Verified: 2025-10-30

Counselor - Professional Primary Specialty

NUCC Taxonomy Code: 101YP2500X

State License KY 297949

Definition to come...

Counselor - Addiction (Substance Use Disorder)

NUCC Taxonomy Code: 101YA0400X

State License KY 280595

Definition to come...

Secondary Practice Locations

1143 Fairway St Ste 103

Bowling Green, KY 421032452

Phone: 4073474539

Career & Practice History Timeline

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

16 Historical Events

📍

Updated Business Mailing Address October 30, 2025

Registered at 1143 FAIRWAY ST STE 103, BOWLING GREEN, KY 421032452 (Tel: 4073474536)

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) October 30, 2025

Counselor (License #297949 in KY)

👤

Provider Name / Credentials Updated March 29, 2025

Recorded as ANTHONY JACKSON, MA, LPCC, LCADC

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) March 29, 2025

Counselor (License #280595 in KY)

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) March 08, 2023

Counselor (License #280600 in KY)

📍

Updated Practice Location August 19, 2021

Registered at 6445 EAST HAVEN WAY, ALVATON, KY 42122 (Tel: 5025096116)

📍

Updated Business Mailing Address August 19, 2021

Registered at 6445 EAST HAVEN WAY, ALVATON, KY 42122 (Tel: 2709968612)

📍

Updated Business Mailing Address January 20, 2021

Registered at 1351 WALNUT WAY, BOWLING GREEN, KY 421044307 (Tel: 2709968612)

👤

Provider Name / Credentials Updated January 20, 2021

Recorded as ANTHONY JACKSON, CADC

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) January 20, 2021

Counselor (License #266965 in KY)

✅

NPI Profile Active May 15, 2019

NPI status registered as active in NPPES database

📍

Updated Practice Location May 15, 2019

Registered at 5080 FLORENCE RD, MURFREESBORO, TN 371292922 (Tel: 5029968612)

📍

Updated Business Mailing Address May 15, 2019

Registered at 5080 FLORENCE RD, MURFREESBORO, TN 371292922 (Tel: 5029968612)

👤

Provider Name / Credentials Updated May 15, 2019

Recorded as ANTHONY JACKSON, TCADC

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) May 15, 2019

Counselor (License #175242 in KY)

🟢

Initial NPI Registration & Enumeration May 15, 2019

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

0 Reviews

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NPI Administrative Meta

NPI Number: 1487210399

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: May 15, 2019

Last Update: October 30, 2025

Sole Proprietor: No

Update or Correct Profile

Mailing Address

1143 Fairway St Ste 103

Bowling Green, KY 421032452

Phone: 4073474536

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.