Individual provider · Type 1 NPI
Jacquelyn Angela Jackson, LMHC
Mental Health Counselor · Huntington Station, NY
NPI number
1003575010
Active
Practice location
172 W 21st St
Huntington Station, NY 11746-2122
Mailing address
3 Winterbrooke Rd
Moodus, CT 06469-1190
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Mental Health Counselor Primary | 101YM0800X | 012735 (NY) |
| Mental Health Counselor | 101YM0800X | None listed |
Mental Health Counselor: Definition to come...
Another provider at this address
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About NPI 1003575010
Jacquelyn Angela Jackson, LMHC's National Provider Identifier is 1003575010, issued on Dec 17, 2021. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Huntington Station, NY. The record was last updated on Sep 17, 2026.