Individual provider · Type 1 NPI

Audra Laurelle Jackson, SAC-IT

Addiction (Substance Use Disorder) Counselor · Friendship, WI

NPI number 1679471171 Active

Practice location

108 E North St
Friendship, WI 53934-9422

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400X21272-130 (WI)

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1679471171

Audra Laurelle Jackson, SAC-IT's National Provider Identifier is 1679471171, issued on Oct 27, 2026. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Friendship, WI. The record was last updated on Oct 27, 2026.