Active NPI 1659923209 Individual Practitioner Female Practitioner

Jackalynn Lee Wilson

Counselor - Professional • Old Forge, PA

Public Directory Information & Medical Disclaimer

This profile is compiled from official public domain records provided by CMS and the NPPES registry. TRUE-MEDINFO is an independent reference directory and does not provide medical advice, diagnosis, or treatment recommendations. Always consult a licensed medical professional for personal health decisions.

Professional Overview & Biography Verified Profile Summary

Jackalynn Wilson is a registered healthcare professional specializing in Counselor - Professional in Old Forge, PA. Official NPI practice address is registered at 118 AMITY AVE.

Practice Location & Contact Primary Location

Practice Address

118 Amity Ave

Old Forge, PA 185181019

Telephone 5709050669

Associated Practice Facility / Clinic

🏢 Hidden Grove Art Therapy Llc Facility NPI 1700739935

Specialty Benchmarks & Practice Insights

Comparative analytics for Counselor - Professional in Old Forge, PA

Active Practitioner

Practitioner Clinical Experience

Active

City Avg: 10.5 Yrs

State Avg: 13.9 Yrs

Regional Practice Density

8 Specialists

Practicing in Old Forge, PA (9514 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

Medical Specialties & State Licenses

CMS Verified: 2026-02-17

Counselor - Professional Primary Specialty

NUCC Taxonomy Code: 101YP2500X

State License PA PC011549

Definition to come...

Career & Practice History Timeline

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

10 Historical Events

📍

Updated Practice Location February 17, 2026

Registered at 118 AMITY AVE, OLD FORGE, PA 185181019 (Tel: 5709050669)

📍

Updated Practice Location August 18, 2023

Registered at 1169 WYOMING AVE, FORTY FORT, PA 187044003 (Tel: 5709047363)

👤

Provider Name / Credentials Updated February 01, 2022

Recorded as JACKALYNN WILSON

📍

Updated Practice Location December 14, 2020

Registered at 501 S WASHINGTON AVE STE 1000, SCRANTON, PA 185053814 (Tel: 5709410630)

✅

NPI Profile Active July 14, 2019

NPI status registered as active in NPPES database

📍

Updated Practice Location July 14, 2019

Registered at 639 MAIN ST, AVOCA, PA 186411558 (Tel: 5704767704)

📍

Updated Business Mailing Address July 14, 2019

Registered at 118 AMITY AVE, OLD FORGE, PA 185181019 (Tel: 5709050669)

👤

Provider Name / Credentials Updated July 14, 2019

Recorded as JACKALYNN SHUKIS

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) July 14, 2019

Counselor (License #PC011549 in PA)

🟢

Initial NPI Registration & Enumeration July 14, 2019

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: 1659923209

Entity Type:

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

Enumeration Date: July 14, 2019

Last Update: February 17, 2026

Sole Proprietor: Yes

Update or Correct Profile

Mailing Address

118 Amity Ave

Old Forge, PA 185181019

Phone: 5709050669

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.