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Individual

MR. CASEY JACKSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MSW, LICSW

Contact information

Practice address
1124 W RIVERSIDE AVE, SUITE LL2, SPOKANE, WA 99201-1132
(509) 981-9851
Mailing address
1124 W RIVERSIDE AVE, SUITE LL2, SPOKANE, WA 99201-1132
(509) 981-9851

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CP00001054
WA
1041C0700X
Clinical Social Worker
LW00004476
WA

Other

Enumeration date
05/19/2007
Last updated
09/11/2025
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