Individual
MRS. CHARITY WEAVER JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LGPC, NCACII
Contact information
Practice address
2112 F ST NW STE 102, WASHINGTON, DC 20037-2722
(202) 349-3212
Mailing address
4822 41ST ST NW, WASHINGTON, DC 20016-1708
(252) 646-6860
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1407
DC
101YP2500X
Professional Counselor
Primary
LGPC00618
DC
Other
Enumeration date
03/23/2021
Last updated
03/23/2021
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