Individual
KENDALL L JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCPC
Contact information
Practice address
1020 N 27TH ST, BILLINGS, MT 59101-0760
(406) 238-2500
Mailing address
PO BOX 35100, BILLINGS, MT 59107-5100
(406) 238-2500
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
315 LCPC
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000744340
BCBS PIN
MT
05
—
0252858
—
MT
Enumeration date
02/21/2007
Last updated
12/03/2014
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