Individual provider · Type 1 NPI

Justin Jackson, LPC

Professional Counselor · Glen Allen, VA

NPI number 1235788902 Active

Practice location

4212 Park Place Ct
Glen Allen, VA 23060-3314

Fax (804) 728-1086

Specialties and licenses

TaxonomyCodeLicense
Counselor 101Y00000X0701008565 (VA)
Addiction (Substance Use Disorder) Counselor 101YA0400X0701008565 (VA)
Mental Health Counselor 101YM0800X0701008565 (VA)
Professional Counselor Primary 101YP2500X0701008565 (VA)

Professional Counselor: Definition to come...

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About NPI 1235788902

Justin Jackson, LPC's National Provider Identifier is 1235788902, issued on Sep 5, 2019. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Glen Allen, VA. The record was last updated on Aug 20, 2021.