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Individual

MR. JAMES C JACKSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LPC

Contact information

Practice address
800 PRESTON AVE, CHARLOTTESVILLE, VA 22903-4420
(434) 792-1800
Mailing address
71 TANBARK PLAZA, LOVINGSTON, VA 22949
(434) 263-4889

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0701001993
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
004945018
VA
Enumeration date
02/15/2007
Last updated
12/10/2010
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