Individual provider · Type 1 NPI
Angelique Alexandria Wilkes Jackson, LPC, LAC, LPCC, LMHC
Mental Health Counselor · Queen Creek, AZ
NPI number
1801791744
Active
Practice location
19512 S 208th Pl
Queen Creek, AZ 85142-1616
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Mental Health Counselor | 101YM0800X | LAC-24310 (AZ) |
| Mental Health Counselor | 101YM0800X | LPCC.0025111 (CO) |
| Mental Health Counselor | 101YM0800X | MCHA.MC.70155466 (WA) |
| Mental Health Counselor Primary | 101YM0800X | C.2608359 (OH) |
Mental Health Counselor: Definition to come...
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About NPI 1801791744
Angelique Alexandria Wilkes Jackson, LPC, LAC, LPCC, LMHC's National Provider Identifier is 1801791744, issued on Oct 12, 2026. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Queen Creek, AZ. The record was last updated on Oct 12, 2026.