Individual provider · Type 1 NPI
Mary Elisabeth Jackson, LCPC
Counselor · Carbondale, IN
NPI number
1437456522
Active
Practice location
804 South Oakland Ave
Carbondale, IN 62901
Fax (618) 529-2182
Mailing address
804 S Oakland Ave
Carbondale, IL 62901-2555
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Counselor Primary | 101Y00000X | 180.007729 (IL) |
Counselor: A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.
About NPI 1437456522
Mary Elisabeth Jackson, LCPC's National Provider Identifier is 1437456522, issued on Feb 25, 2011. The primary taxonomy on file is Counselor (101Y00000X), and the practice location is in Carbondale, IN. The record was last updated on Feb 25, 2011.