Individual
STEVEN WAYNE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
1941 S 42ND ST STE 514, OMAHA, NE 68105
(402) 614-8444
Mailing address
401 S 23RD ST, WORLAND, WY 82401-3725
(307) 347-6165
(307) 347-6166
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YP2500X
Professional Counselor
Primary
1194
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1194
MENTAL HEALTH PROFESSIONS LICENSING BOARD
WY
Enumeration date
04/21/2010
Last updated
06/12/2018
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