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Individual

JAMES L JACKSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MSW,LICDC

Contact information

Practice address
PO BOX 13367, TOLEDO, OH 43613-0367
(616) 212-9802
Mailing address
PO BOX 13367, TOLEDO, OH 43613-0367
(616) 212-9802

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
101193
OH
101YM0800X
Mental Health Counselor
Primary
1101526
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
101193
LICDC
OH
01
1101526
LSW
OH
Enumeration date
06/18/2013
Last updated
02/24/2026
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