Individual
MELANIE J JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, LMHC, NCC
Contact information
Practice address
5840 RED BUG LAKE RD, #1548, WINTER SPRINGS, FL 32708-5011
(423) 342-6422
(407) 695-8803
Mailing address
5840 RED BUG LAKE RD, #1548, WINTER SPRINGS, FL 32708-5011
(423) 342-6422
(407) 695-8803
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
NCC 33945
NC
101YM0800X
Mental Health Counselor
MH 3045
FL
101YP2500X
Professional Counselor
Primary
18548
TX
Other
Enumeration date
06/29/2010
Last updated
06/08/2020
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