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Individual

SHERKEITH JACKSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1606 GLOUCESTER ST STE 5, BRUNSWICK, GA 31520-7145
(607) 205-9186
(540) 225-9700
Mailing address
1606 GLOUCESTER ST STE 5, BRUNSWICK, GA 31520-7145
(607) 205-9186
(540) 225-9700

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
23255663
GA
103TC2200X
Clinical Child & Adolescent Psychologist
23255663
GA
251B00000X
Case Management Agency
23255663
GA
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
23255663
GA

Other

Enumeration date
07/19/2025
Last updated
07/21/2025
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