Individual
CHERYL ANN JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW, CAADC, CCS
Contact information
Practice address
2901 S ETHEL ST, DETROIT, MI 48217-1531
(313) 775-6335
Mailing address
2901 S ETHEL ST, DETROIT, MI 48217-1531
(313) 775-6335
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
Primary
6801092435
MI
171M00000X
Case Manager/Care Coordinator
—
—
172V00000X
Community Health Worker
—
—
Other
Enumeration date
10/01/2010
Last updated
08/02/2024
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