Individual
JORDAN JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LCMHCA
Contact information
Practice address
800 N RALEIGH ST, ANGIER, NC 27501-8613
(910) 489-6994
Mailing address
42 SALTWATER CV, CLAYTON, NC 27520-3665
(984) 989-3566
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
A21381
NC
101YM0800X
Mental Health Counselor
Primary
A21381
—
Other
Enumeration date
05/14/2025
Last updated
05/14/2025
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