Individual provider · Type 1 NPI
Joseph Granville Jackson, CCS, RAC
Addiction (Substance Use Disorder) Counselor · Lake Providence, LA
NPI number
1891152773
Active
Practice location
411 Sparrow St
Lake Providence, LA 71254-3035
Fax (318) 559-2044
Mailing address
706 Sparrow St
Lake Providence, LA 71254-3520
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Addiction (Substance Use Disorder) Counselor Primary | 101YA0400X | 186 (LA) |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 1300 (LA) |
Addiction (Substance Use Disorder) Counselor: Definition to come...
4 other providers at this address
- Delta Community Action Association, Inc.Community/Behavioral Health Agency Lake Providence, LA NPI 1700233079
- Delta Community Enhancement ProgramCommunity/Behavioral Health Agency Lake Providence, LA NPI 1639612476
- Alisa BellMental Health Counselor Lake Providence, LA NPI 1306317953
- Elisha LucasMental Health Counselor Lake Providence, LA NPI 1578005906
About NPI 1891152773
Joseph Granville Jackson, CCS, RAC's National Provider Identifier is 1891152773, issued on Jan 22, 2016. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Lake Providence, LA. The record was last updated on Jan 22, 2016.