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Individual
JUANITA JACKSON
Active
Individual
JUANITA JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
0701008926
VA
101YM0800X
Mental Health Counselor
Primary
LC7981
MD
101YM0800X
Mental Health Counselor
LGPC00202
DC
Other
Enumeration date
01/22/2017
Last updated
11/04/2025
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