Individual
LILLIAN L JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
108 E RIDGEVILLE BLVD STE A, MOUNT AIRY, MD 21771-5934
(667) 770-6549
(866) 949-4549
Mailing address
PO BOX 985, MOUNT AIRY, MD 21771-0985
(443) 713-5746
(866) 949-4549
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
LC12160
MD
101YA0400X
Addiction (Substance Use Disorder) Counselor
LC12160
MD
101YM0800X
Mental Health Counselor
Primary
LC12160
MD
101YP1600X
Pastoral Counselor
LC12160
MD
101YP2500X
Professional Counselor
LC12160
MD
Other
Enumeration date
05/23/2019
Last updated
09/18/2025
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