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Individual
MARCELLA JACKSON
Active
Individual
MARCELLA JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
18439
MD
101YP2500X
Professional Counselor
18439
MD
104100000X
Social Worker
18439
MD
251B00000X
Case Management Agency
18439
MD
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
18439
MD
Other
Enumeration date
11/09/2022
Last updated
01/07/2023
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