Individual
MISS CHERLISA JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, MPH, LPC, CHES
Contact information
Practice address
5835 CAMPBELLTON RD SW STE 102, ATLANTA, GA 30331-8014
(470) 440-0058
Mailing address
PO BOX 311733, ATLANTA, GA 31131-1733
(470) 440-0058
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC011598
GA
101YP2500X
Professional Counselor
APC004613
GA
Other
Enumeration date
12/21/2015
Last updated
11/27/2023
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