Individual
JESSICA J JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
3939 LAVISTA RD STE E349, TUCKER, GA 30084-5162
(470) 778-8754
Mailing address
3939 LAVISTA RD STE E349, TUCKER, GA 30084-5162
(470) 778-8754
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
LPC015486
GA
101YP2500X
Professional Counselor
Primary
LPC015486
GA
Other
Enumeration date
07/01/2025
Last updated
07/01/2025
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