Individual provider · Type 1 NPI

Samyiah Destiny Jackson

Counselor · Bridgeport, CT

NPI number 1497683957 Active

Practice location

46 Albion St
Bridgeport, CT 06605-2602

Call (203) 332-4645 Map

Fax (203) 382-1436

Mailing address

485 Anson St
Bridgeport, CT 06606-4704

Specialties and licenses

TaxonomyCodeLicense
Counselor Primary 101Y00000XNone listed

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.

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About NPI 1497683957

Samyiah Destiny Jackson's National Provider Identifier is 1497683957, issued on May 13, 2026. The primary taxonomy on file is Counselor (101Y00000X), and the practice location is in Bridgeport, CT. The record was last updated on May 13, 2026.