Individual provider · Type 1 NPI
Tanaya Moon Jackson, LPC
Professional Counselor · Casper, WY
NPI number
1659558807
Active
Practice location
5915 Thirty Three Mile Rd
Casper, WY 82604-9585
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Professional Counselor Primary | 101YP2500X | LPC-1179 (WY) |
Professional Counselor: Definition to come...
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About NPI 1659558807
Tanaya Moon Jackson, LPC's National Provider Identifier is 1659558807, issued on Jan 29, 2008. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Casper, WY. The record was last updated on Sep 25, 2025.