Organization
LIFECARE COUNSELING SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRENT A JACKSON LPC (DIRECTOR)
(417) 234-9023
Entity
Organization
Contact information
Practice address
3318 S BLACKMAN AVE, SPRINGFIELD, MO 65809-4163
(417) 234-9023
Mailing address
3318 S BLACKMAN AVE, SPRINGFIELD, MO 65809-4163
(417) 234-9023
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2006005127
MO
Other
Enumeration date
03/20/2009
Last updated
03/20/2009
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