Individual provider · Type 1 NPI

Charlesetta Jackson, SAC

Addiction (Substance Use Disorder) Counselor · Milwaukee, WI

NPI number 1922273879 Active

Practice location

4757 N 76th St
Milwaukee, WI 53218-4732

Call (414) 358-4171 Map

Fax (414) 358-5005

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400X15371-131 (WI)

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

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About NPI 1922273879

Charlesetta Jackson, SAC's National Provider Identifier is 1922273879, issued on Apr 22, 2008. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Milwaukee, WI. The record was last updated on Apr 22, 2008.