Individual provider · Type 1 NPI

Modeacon Latrell Jackson Sr.

Mental Health Counselor · Monroe, LA

NPI number 1891208823 Active

Practice location

1702 Bernstein Park Rd
Monroe, LA 71202-5502

Call (318) 331-3440 Map

Other practice locations

  • 1702 Bernstein Park Rd, Monroe, LA 71202-5502 · (318) 331-3440

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

Mental Health Counselor: Definition to come...

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About NPI 1891208823

Modeacon Latrell Jackson Sr.'s National Provider Identifier is 1891208823, issued on Nov 13, 2017. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Monroe, LA. The record was last updated on Mar 17, 2018.