Individual
MR. REGINALD CHRISTOPHER JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LSCSW
Contact information
Practice address
901 KENTUCKY ST STE 306, LAWRENCE, KS 66044-2858
(816) 377-7398
(816) 873-1364
Mailing address
901 KENTUCKY ST STE 306, LAWRENCE, KS 66044-2858
(816) 377-7398
(816) 873-1364
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
2015021883
MO
1041C0700X
Clinical Social Worker
Primary
4352
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200629810C
—
KS
Enumeration date
11/03/2009
Last updated
02/22/2018
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