Individual provider · Type 1 NPI

Derisha Jackson

Counselor · Midwest City, OK

NPI number 1780968628 Active

Practice location

351 N Air Depot Blvd, Suite S
Midwest City, OK 73110-1700

Call (405) 610-6540 Map

Mailing address

13525 N Hollow Rock Rd., Apt D
Oklahoma City, OK 73120

Specialties and licenses

TaxonomyCodeLicense
Counselor Primary 101Y00000XNone listed

Counselor: A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.

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About NPI 1780968628

Derisha Jackson's National Provider Identifier is 1780968628, issued on Oct 10, 2011. The primary taxonomy on file is Counselor (101Y00000X), and the practice location is in Midwest City, OK. The record was last updated on Oct 10, 2011.