Organization
INSPIRED PEACE COUNSELING SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOMINIQUE JACKSON LCSW (COO/ PSYCHOTHERAPIST)
(219) 613-7872
Entity
Organization
Contact information
Practice address
3009 WINTER GARDEN DR, VALPARAISO, IN 46385-7140
(219) 508-5646
Mailing address
3009 WINTER GARDEN DR, VALPARAISO, IN 46385-7140
(219) 508-5646
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1801487574
BUSINESS NPI
—
01
—
1891382339
PROVIDER NPI
IN
05
—
300067700
—
IN
Enumeration date
01/26/2021
Last updated
02/25/2026
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