Individual
TIFFANY JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
312 SW GREENWICH DR STE 579, LEES SUMMIT, MO 64082-4408
(870) 413-6905
Mailing address
312 SW GREENWICH DR STE 579, LEES SUMMIT, MO 64082-4408
(870) 413-6905
(870) 515-4029
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
2021012242
MO
101YM0800X
Mental Health Counselor
Primary
A1308078
AR
101YM0800X
Mental Health Counselor
P1607095
AR
Other
Enumeration date
11/06/2014
Last updated
09/30/2025
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