Individual provider · Type 1 NPI

Jackson T. Douglas, LPC

Professional Counselor · Springfield, MO

NPI number 1356695183 Active

Practice location

1300 E Bradford Pkwy
Springfield, MO 65804-4264

Call (417) 761-5000 Map

Fax (417) 761-5111

Other practice locations

  • 875 W Moreno Ave, Colorado Springs, CO 80905-1731 · (719) 572-6100

Specialties and licenses

TaxonomyCodeLicense
Counselor 101Y00000XNone listed
Professional Counselor Primary 101YP2500X2014040178 (MO)

Professional Counselor: Definition to come...

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About NPI 1356695183

Jackson T. Douglas, LPC's National Provider Identifier is 1356695183, issued on Oct 31, 2012. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Springfield, MO. The record was last updated on Aug 22, 2022.