Individual
ADRIAKA Y JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
5123 MILHOUSE RD, INDIANAPOLIS, IN 46221-4213
(317) 835-3435
Mailing address
5123 MILHOUSE RD, INDIANAPOLIS, IN 46221-4213
(317) 835-3435
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
99092140A
IN
101YM0800X
Mental Health Counselor
Primary
39004508A
IN
101YM0800X
Mental Health Counselor
TPMC5365
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8973191013
8973191013
IN
Enumeration date
10/25/2019
Last updated
03/17/2026
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