Individual
STACEY L JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
131 CAMERON ST, PACOLET, SC 29372-2838
(864) 398-9322
(888) 707-1002
Mailing address
131 CAMERON ST, PACOLET, SC 29372-2838
(864) 398-9322
(888) 707-1002
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC.5354 PC
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PC1558
—
SC
Enumeration date
03/18/2009
Last updated
05/07/2025
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