Update this page – If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS.
Individual
MISS TRINICIA RENEE LAVON JACKSON
Active
Individual
MISS TRINICIA RENEE LAVON JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
7112
SC
101YM0800X
Mental Health Counselor
Primary
7802
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PC2451
—
SC
Enumeration date
07/02/2020
Last updated
09/09/2021
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