Individual
KENNETH LEE JACKSON JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LSW; LCDC III
Contact information
Practice address
1430 S HIGH ST FL 4, COLUMBUS, OH 43207-1045
(614) 445-8131
(614) 643-6820
Mailing address
1430 S HIGH ST FL 4, COLUMBUS, OH 43207-1045
(614) 445-8131
(614) 643-6820
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
S.1700069
OH
Other
Enumeration date
10/24/2017
Last updated
10/24/2017
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