Individual
MR. JACKSON B PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CMHC
Contact information
Practice address
901 PRESTON AVE STE 401, CHARLOTTESVILLE, VA 22903-4491
(434) 218-0405
Mailing address
1549 DELPHI LN, CHARLOTTESVILLE, VA 22911-3658
(434) 218-0405
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0704018305
VA
Other
Enumeration date
10/28/2025
Last updated
10/28/2025
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