Individual provider · Type 1 NPI
Kimberly Jackson
Addiction (Substance Use Disorder) Counselor · Highland, UT
NPI number
1780319939
Active
Practice location
11042 N 5500 W
Highland, UT 84003-9503
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Addiction (Substance Use Disorder) Counselor Primary | 101YA0400X | 142864226001 (UT) |
| Clinical Social Worker | 1041C0700X | 142864223502 (UT) |
Addiction (Substance Use Disorder) Counselor: Definition to come...
About NPI 1780319939
Kimberly Jackson's National Provider Identifier is 1780319939, issued on Jul 21, 2022. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Highland, UT. The record was last updated on May 19, 2026.