Individual provider · Type 1 NPI

Lynette Jackson

Mental Health Counselor · Modesto, CA

NPI number 1154288256 Active

Practice location

2200 Standiford Ave Apt 126
Modesto, CA 95350-6540

Call (209) 569-3351 Map

Fax (209) 290-3587

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor 101YA0400X202030210947 (CA)
Health & Wellness Coach 171400000X202030210947 (CA)
Contractor 171W00000X202030210947 (CA)
Case Manager/Care Coordinator 171M00000X202030210947 (CA)
Health Educator 174H00000X202030210947 (CA)
Home Health Agency 251E00000X202030210947 (CA)
Homeopath 175L00000X202030210947 (CA)
Local Education Agency (LEA) 251300000X202030210947 (CA)
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X202030210947 (CA)
Case Management Agency 251B00000X202030210947 (CA)
Mental Health Counselor Primary 101YM0800X202030210947 (CA)

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About NPI 1154288256

Lynette Jackson's National Provider Identifier is 1154288256, issued on Jan 8, 2026. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Modesto, CA. The record was last updated on Feb 10, 2026.