Individual
SHEREKA M JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
914 E BROADWAY, LOUISVILLE, KY 40204-1037
(502) 589-5878
(502) 589-8758
Mailing address
1949 GOLDSMITH LN STE 103, LOUISVILLE, KY 40218-3096
(502) 296-4657
(502) 785-4003
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
254269
KY
Other
Enumeration date
07/05/2019
Last updated
08/26/2022
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