Individual
MRS. NICOLE A JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW-C
Contact information
Practice address
11810 PRESGRAVES RD, REISTERSTOWN, MD 21136-3298
(443) 271-7449
Mailing address
11810 PRESGRAVES RD, REISTERSTOWN, MD 21136-3298
(443) 271-7449
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
22666
MD
1041S0200X
School Social Worker
Primary
22666
MD
Other
Enumeration date
07/16/2018
Last updated
05/30/2025
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