Organization
CENTER FOR WISE COUNSEL, LLC
Active
Other names
Center for Wise Counsel, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
SHERRY A C JACKSON LPC, LSATP, MAC,CSAC (CEO)
(571) 545-0592
Entity
Organization
Contact information
Practice address
12849 GALVESTON CT # 120, MANASSAS, VA 20112-8676
(571) 545-0592
(855) 955-1268
Mailing address
12849 GALVESTON CT # 120, MANASSAS, VA 20112-8676
(571) 545-0592
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1225094451
—
VA
01
—
1538852462
NPPES- GROUP NPI
—
01
—
1902232333
NPPES- INDIVIDUAL NPI
—
Enumeration date
05/26/2023
Last updated
01/13/2025
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