Individual provider · Type 1 NPI

Willye Dorethea Jackson, MSW

Mental Health Counselor · Los Angeles, CA

NPI number 1154440287 Active

Practice location

439 W 97th St
Los Angeles, CA 90003-3968

Call (323) 754-2856 Map

Fax (323) 754-1843

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XASW23815 (CA)

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About NPI 1154440287

Willye Dorethea Jackson, MSW's National Provider Identifier is 1154440287, issued on Mar 28, 2007. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Los Angeles, CA. The record was last updated on May 28, 2013.