Individual provider · Type 1 NPI

Staci Nicole Jackson

Mental Health Counselor · Baton Rouge, LA

NPI number 1003329160 Active

Practice location

11616 Southfork Ave
Baton Rouge, LA 70816-5241

Call (225) 291-9646 Map

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

Mental Health Counselor: Definition to come...

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About NPI 1003329160

Staci Nicole Jackson's National Provider Identifier is 1003329160, issued on Nov 13, 2017. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Baton Rouge, LA. The record was last updated on Nov 13, 2017.