Individual
MR. JOHN EDWARD JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BS MS,LMHC,CAP
Contact information
Practice address
1851 NW 123RD AVE, PEMBROKE PINES, FL 33026-3825
(954) 432-2100
Mailing address
6022 NW 91ST WAY, TAMARAC, FL 33321-4100
(954) 720-5523
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
3282
FL
101YM0800X
Mental Health Counselor
MH8379
FL
Other
Enumeration date
04/25/2007
Last updated
09/11/2025
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