Individual
ALICIA JEREE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW, LCADC
Contact information
Practice address
65 ENERGY RD, FLEMINGSBURG, KY 41041-9806
(606) 405-6557
(606) 209-0044
Mailing address
65 ENERGY RD, FLEMINGSBURG, KY 41041-9806
(606) 748-9090
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
266966
KY
101YM0800X
Mental Health Counselor
Primary
255943
KY
Other
Enumeration date
07/17/2019
Last updated
05/12/2023
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