Individual provider · Type 1 NPI

Tishara A. Jackson, ED.D, LCDC, CSC

Mental Health Counselor · Fort Worth, TX

NPI number 1477319119 Active

Practice location

8201 Southbrook Cir
Fort Worth, TX 76134-5332

Call (773) 996-3797 Map

Mailing address

5613 Mount Storm Way
Fort Worth, TX 76179-4438

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800X15299 (TX)

Mental Health Counselor: Definition to come...

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About NPI 1477319119

Tishara A. Jackson, ED.D, LCDC, CSC's National Provider Identifier is 1477319119, issued on Feb 21, 2024. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Fort Worth, TX. The record was last updated on Apr 2, 2025.