Individual provider · Type 1 NPI

Nicole M. Jackson, MA, LPC, LCADC

Professional Counselor · West Long Branch, NJ

NPI number 1205017803 Active

Practice location

232 Norwood Ave, Suite 5
West Long Branch, NJ 07764-1859

Call (732) 948-2132 Map

Specialties and licenses

TaxonomyCodeLicense
Counselor 101Y00000X37PC00345200 (NJ)
Addiction (Substance Use Disorder) Counselor 101YA0400X37LC00119500 (NJ)
Professional Counselor Primary 101YP2500X37PC00345200 (NJ)

Professional Counselor: Definition to come...

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About NPI 1205017803

Nicole M. Jackson, MA, LPC, LCADC's National Provider Identifier is 1205017803, issued on Nov 25, 2007. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in West Long Branch, NJ. The record was last updated on Sep 29, 2008.