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Organization

CULTURALLY COMPETENT THERAPY PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ANGELA DECARLA JACKSON PH.D., LCPC, LMHC (OWNER)
(312) 798-9755
Entity
Organization

Contact information

Practice address
1251 N EDDY ST STE 200, SOUTH BEND, IN 46617-1478
(312) 798-9755
Mailing address
1251 N EDDY ST STE 200, SOUTH BEND, IN 46617-1478
(312) 798-9755

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary

Other

Enumeration date
05/06/2020
Last updated
06/25/2025
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