Individual
MARSHA D JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.ED.,L.M.S.W.,L.P.C
Contact information
Practice address
2400 W MAIN ST, ROCK HILL, SC 29732-8968
(803) 327-6103
(803) 328-5443
Mailing address
PO BOX 68, ROCK HILL, SC 29731-6068
(803) 327-6103
(803) 328-5443
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
1597
SC
1041C0700X
Clinical Social Worker
2842
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
570629234006
BCBS
SC
Enumeration date
11/21/2006
Last updated
05/09/2008
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