# JACKSON PSYCHOTHERAPY, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** The Satori Program
- **Organization subpart:** No

## Provider details

- **NPI number:** 1154846533
- **Authorized official:** REGINALD C. JACKSON LSCSW, LCSW (OWNER/EXECUTIVE DIRECTOR)
- **Authorized official phone:** (816) 377-7398

## Contact information

- **Practice address:** 901 KENTUCKY ST STE 306, LAWRENCE, KS 66044-2858
- **Practice address phone:** (816) 377-7398
- **Practice address fax:** (816) 873-1364
- **Mailing address:** 901 KENTUCKY ST STE 306, LAWRENCE, KS 66044-2858
- **Mailing address phone:** (816) 377-7398
- **Mailing address fax:** (816) 873-1364

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | — | NULL | Yes |
| 1041C0700X | Clinical Social Worker | — | — | Yes |

## Other

- **Enumeration date:** 08/07/2017
- **Last updated:** 07/21/2022