Individual
JENNIFER JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW-A/LCAS-A
Contact information
Practice address
2101 GARNER RD, RALEIGH, NC 27610-4687
(919) 832-7351
(919) 571-2932
Mailing address
2101 GARNER RD, RALEIGH, NC 27610-4687
(919) 832-7351
(919) 571-2932
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
3468-A
NC
101YM0800X
Mental Health Counselor
Primary
P008214
NC
Other
Enumeration date
02/10/2014
Last updated
02/10/2014
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