Organization
JACKSON MENTAL HEALTH SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOMINIQUE JACKSON PMHNP-C (OWNER)
(601) 589-4854
Entity
Organization
Contact information
Practice address
1035 COURTNEY RD, HERMANVILLE, MS 39086-7700
(601) 448-9924
(601) 202-4010
Mailing address
1035 COURTNEY RD, HERMANVILLE, MS 39086-7700
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
10/17/2025
Last updated
04/29/2026
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