# MRS. LAURA K JACKSON

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1326224288
- **Gender:** F
- **Credential:** LCSW; LCDC III

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | LCDC III- 101140 | OH | — |
| 1041C0700X | Clinical Social Worker | LCSW 3952 | KY | Yes |
| 1041C0700X | Clinical Social Worker | LSW-09000933 | OH | — |

## Other

- **Enumeration date:** 01/10/2008
- **Last updated:** 09/30/2014