Individual
ERICA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
470 E LOCKWOOD AVE, SAINT LOUIS, MO 63119-3194
(800) 981-9801
Mailing address
1270 N WICKHAM RD STE 16-705, MELBOURNE, FL 32935-8923
(321) 216-7875
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
07/20/2021
Last updated
02/04/2026
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