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Organization
THE SOURCE COUNSELING, CASE MANAGEMENT AND CONSULTATION
Active
Organization
THE SOURCE COUNSELING, CASE MANAGEMENT AND CONSULTATION
Active
Other names
The Source
Organization subpart
No
Provider details
NPI number
Authorized official
SHANNA JACKSON LPC (OWNER/ COUNSELOR)
(313) 544-3513
Entity
Organization
Contact information
Practice address
29277 SOUTHFIELD RD STE C, SOUTHFIELD, MI 48076-1922
(313) 409-8073
Mailing address
18007 JULIANA AVE, EASTPOINTE, MI 48021-3205
(313) 544-3513
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6401013761
MI
Other
Enumeration date
05/23/2018
Last updated
05/23/2018
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