# MARILYN SLEDGE JACKSON/SAFE HARBOR

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1750729646
- **Authorized official:** MRS. MARILYN SLEDGE JACKSON LCSW/PIP (THERAPIST)
- **Authorized official phone:** (334) 235-8158

## Contact information

- **Practice address:** 1040 LONGFIELD CT, MONTGOMERY, AL 36117-8055
- **Practice address phone:** (334) 288-9009
- **Practice address fax:** (334) 288-9497
- **Mailing address:** 2325 BRIAR GATE DR, MONTGOMERY, AL 36116-2154
- **Mailing address phone:** (334) 235-8158

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | 0942-2160C | AL | — |
| 1041C0700X | Clinical Social Worker | 2160C | AL | Yes |

## Other

- **Enumeration date:** 06/12/2013
- **Last updated:** 06/12/2013