Individual
CHARLES RONALD JACKSON JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2611 LUANA DR APT 101, DISTRICT HEIGHTS, MD 20747-3381
(202) 905-4769
Mailing address
2611 LUANA DR APT 101, DISTRICT HEIGHTS, MD 20747-3381
(202) 905-4769
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
10276273942
MD
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
03/05/2026
Last updated
05/14/2026
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