Individual
SKYLETTE V JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCPC (MD), LPC (VA)
Contact information
Practice address
12302 SOMERSET AVE STE D, PRINCESS ANNE, MD 21853-3099
(443) 614-0829
Mailing address
12302 SOMERSET AVE, PRINCESS ANNE, MD 21853-3099
(443) 614-0829
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1718
DE
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
0701015474
VA
101YM0800X
Mental Health Counselor
Primary
LC17807
MD
Other
Enumeration date
04/25/2018
Last updated
04/24/2026
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