Individual
ALEXIS DIONNA JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSWA
Contact information
Practice address
501 N 2ND ST, RICHMOND, VA 23219-1359
(804) 828-9452
(804) 828-9282
Mailing address
PO BOX 780125, PHILADELPHIA, PA 19178-0125
(804) 922-4844
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
NC
1041C0700X
Clinical Social Worker
Primary
0904014698
VA
374J00000X
Doula
—
VA
Other
Enumeration date
11/29/2021
Last updated
06/13/2023
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