Individual provider · Type 1 NPI

Kenneth Alan Jackson, BS, LADC

Addiction (Substance Use Disorder) Counselor · Minneapolis, MN

NPI number 1891085783 Active

Practice location

3329 University Ave SE
Minneapolis, MN 55414-3325

Call (612) 454-2285 Map

Fax (612) 454-2340

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400X302997 (MN)

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

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About NPI 1891085783

Kenneth Alan Jackson, BS, LADC's National Provider Identifier is 1891085783, issued on Apr 12, 2011. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Minneapolis, MN. The record was last updated on Apr 12, 2011.