Individual
NICHOLAS JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMHC
Contact information
Practice address
2756 POST RD, WARWICK, RI 02886-3003
(401) 691-6000
(401) 738-7718
Mailing address
2756 POST RD, WARWICK, RI 02886-3003
(401) 691-6000
(401) 738-7718
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MHC00475
RI
Other
Enumeration date
09/03/2010
Last updated
09/03/2010
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