Individual provider · Type 1 NPI
Irene Dormenie Jackson, LCMHC, LCAS-A
Mental Health Counselor · Durham, NC
NPI number
1053927723
Active
Practice location
904 Woodgreen Dr
Durham, NC 27704-6034
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | LCAS-26084 (NC) |
| Mental Health Counselor Primary | 101YM0800X | 16165 (NC) |
Mental Health Counselor: Definition to come...
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About NPI 1053927723
Irene Dormenie Jackson, LCMHC, LCAS-A's National Provider Identifier is 1053927723, issued on Sep 18, 2020. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Durham, NC. The record was last updated on Oct 24, 2024.