Individual
MR. ANTHONY N. JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA, LPCC, LCADC
Contact information
Practice address
6445 EAST HAVEN WAY, ALVATON, KY 42122
(502) 509-6116
Mailing address
1143 FAIRWAY ST STE 103, BOWLING GREEN, KY 42103-2452
(407) 347-4536
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
280595
KY
101YP2500X
Professional Counselor
Primary
297949
KY
Other
Enumeration date
05/15/2019
Last updated
10/30/2025
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