Individual
KIRSTEN TAMARA JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
9565 SYLVAN STILL RD, LAUREL, MD 20723-1540
(240) 354-7446
Mailing address
9565 SYLVAN STILL RD APT Q, LAUREL, MD 20723-1540
(240) 354-7446
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LC17136
MD
Other
Enumeration date
04/03/2024
Last updated
10/20/2025
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