Individual
DR. SHELLEY ANN JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD, LCMHC
Contact information
Practice address
228 HATHAWAY PT. RD., ST. ALBANS, VT 05478
(940) 641-4186
Mailing address
228 HATHAWAY PT. RD., ST. ALBANS, VT 05478-7200
(940) 641-4186
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
1679098347
VT
101YP2500X
Professional Counselor
15616
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15616
LICENSED PROFESSIONAL COUNSELOR
TX
Enumeration date
08/03/2017
Last updated
10/23/2023
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