Organization
JACKSON COUNSELING ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARROLL S JACKSON MSW,LISW-S (OWNER)
(937) 681-9644
Entity
Organization
Contact information
Practice address
4130 LINDEN AVE STE 250, DAYTON, OH 45432-3048
(937) 681-9644
Mailing address
6504 SEMMES LN, DAYTON, OH 45424-7117
(937) 681-9644
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
06/14/2019
Last updated
06/14/2019
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