Individual
ERICA JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
451 BAXTER AVE STE 201, LOUISVILLE, KY 40204-1177
(502) 383-2969
Mailing address
11103 INDIAN LEGENDS DR APT 202, LOUISVILLE, KY 40241-3488
(859) 539-3683
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
296888
KY
171M00000X
Case Manager/Care Coordinator
—
—
172A00000X
Driver
—
—
Other
Enumeration date
08/06/2019
Last updated
05/16/2025
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