Individual provider · Type 1 NPI
Mary Theresa Jackson, LPC
Professional Counselor · Ellabell, GA
NPI number
1699121129
Active
Practice location
345 Old Cuyler Rd
Ellabell, GA 31308-5858
Other practice locations
- 6605 Abercorn Street, Suite 109C, Savannah, GA 31405 · (912) 320-3205
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Mental Health Counselor | 101YM0800X | None listed |
| Professional Counselor Primary | 101YP2500X | LPC011711 (GA) |
Professional Counselor: Definition to come...
Other professional counselor providers in Ellabell
About NPI 1699121129
Mary Theresa Jackson, LPC's National Provider Identifier is 1699121129, issued on May 13, 2016. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Ellabell, GA. The record was last updated on Nov 27, 2023.