Individual
MS. SYREETA LEA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
530 N MAIN ST, PROVIDENCE, RI 02904-5762
(401) 274-2500
Mailing address
530 N MAIN ST, PROVIDENCE, RI 02904-5762
(401) 595-5788
(401) 595-7662
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
CSW02776
RI
Other
Enumeration date
05/16/2022
Last updated
07/23/2025
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