Individual provider · Type 1 NPI
Jessica Jackson, LPC
Professional Counselor · Bloomington, IL
NPI number
1306426564
Active
Practice location
906 E Chestnut St
Bloomington, IL 61701-3308
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Mental Health Counselor | 101YM0800X | 178.011232 (IL) |
| Professional Counselor Primary | 101YP2500X | 180.014961 (IL) |
Professional Counselor: Definition to come...
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About NPI 1306426564
Jessica Jackson, LPC's National Provider Identifier is 1306426564, issued on Apr 12, 2021. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Bloomington, IL. The record was last updated on Jan 3, 2023.