Individual
CHRIS JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMHC
Contact information
Practice address
144 WATERMAN ST STE 1, PROVIDENCE, RI 02906-2126
(508) 272-8549
Mailing address
56 BOYLSTON AVE, PROVIDENCE, RI 02906-2413
(508) 272-8549
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MHC00056-A
RI
101YM0800X
Mental Health Counselor
Primary
MHC01954
RI
Other
Enumeration date
01/09/2025
Last updated
03/02/2026
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