Individual
CYNTHIA R JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3173 WASHINGTON AVE, BATON ROUGE, LA 70802-2178
(225) 778-7678
(225) 341-6825
Mailing address
3173 WASHINGTON AVE, BATON ROUGE, LA 70802-2178
(225) 778-7678
(225) 341-6825
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
1041S0200X
School Social Worker
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
101Y00000X
PLPC
LA
01
—
251B00000X
PLPC
TX
Enumeration date
10/02/2014
Last updated
04/09/2025
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