Individual
TRACY MARIE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1658 CATALPA RD, CLEVELAND, OH 44112-1007
(216) 403-7276
Mailing address
1658 CATALPA RD, CLEVELAND, OH 44112-1007
(216) 403-7276
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
171W00000X
Contractor
Primary
72652084
OH
Other
Enumeration date
01/15/2026
Last updated
02/17/2026
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