Individual provider · Type 1 NPI

Edward L. Jackson Jr., LPC

Mental Health Counselor · St. Louis, MO

NPI number 1144389917 Active

Practice location

7750 Clayton Rd, Suite 103
St. Louis, MO 63117-1353

Call (314) 647-7708 Map

Fax (314) 645-0359

Mailing address

3807 Keeneland Ct
Florissant, MO 63034-3350

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800X002498 (MO)

Mental Health Counselor: Definition to come...

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About NPI 1144389917

Edward L. Jackson Jr., LPC's National Provider Identifier is 1144389917, issued on Dec 8, 2006. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in St. Louis, MO. The record was last updated on Jul 8, 2007.