Individual
PHILLIP EUGENE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
515 N JEFFERSON AVE, SAINT LOUIS, MO 63103-3000
(314) 652-4100
Mailing address
515 N JEFFERSON AVE, SAINT LOUIS, MO 63103-3000
(314) 652-4100
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
114666
TX
Other
Enumeration date
02/25/2026
Last updated
02/25/2026
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