Individual provider · Type 1 NPI

Candis L. Jackson, LMHC

Mental Health Counselor · Port Charlotte, FL

NPI number 1104004746 Active

Practice location

4161 Tamiami Trl Ste 304D
Port Charlotte, FL 33952-9254

Call (941) 625-5895 Map

Fax (941) 625-1047

Mailing address

PO Box 512139
Punta Gorda, FL 33951-2139

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XMH4441 (FL)

Mental Health Counselor: Definition to come...

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About NPI 1104004746

Candis L. Jackson, LMHC's National Provider Identifier is 1104004746, issued on Feb 6, 2008. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Port Charlotte, FL. The record was last updated on May 7, 2024.