Individual provider · Type 1 NPI

James Jackson

Mental Health Counselor · Lake Providence, LA

NPI number 1417406380 Active

Practice location

1700 Lake St
Lake Providence, LA 71254-5208

Call (318) 559-0551 Map

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

Mental Health Counselor: Definition to come...

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About NPI 1417406380

James Jackson's National Provider Identifier is 1417406380, issued on Oct 3, 2016. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Lake Providence, LA. The record was last updated on Oct 3, 2016.