Individual
MR. CHARLES DUSTIN JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA, LPC
Contact information
Practice address
5004 NW 26TH ST, OKLAHOMA CITY, OK 73127-1722
(405) 923-0603
Mailing address
5004 NW 26TH ST, OKLAHOMA CITY, OK 73127-1722
(405) 923-0603
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
4253
OK
Other
Enumeration date
01/05/2010
Last updated
04/01/2026
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