Individual provider · Type 1 NPI

Courtney Kelly Jackson

Professional Counselor · Charlotte, NC

NPI number 1649060765 Active

Practice location

7401 Carmel Executive Park Dr Ste 210
Charlotte, NC 28226-0406

Fax (704) 544-1109

Specialties and licenses

TaxonomyCodeLicense
Professional Counselor Primary 101YP2500XNone listed

Professional Counselor: Definition to come...

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About NPI 1649060765

Courtney Kelly Jackson's National Provider Identifier is 1649060765, issued on May 12, 2025. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Charlotte, NC. The record was last updated on Jun 15, 2026.