Individual provider · Type 1 NPI

Jackie Jerome Johnson Sr., LCDC-I

Addiction (Substance Use Disorder) Counselor · Lubbock, TX

NPI number 1982114344 Active

Practice location

1715 26th St
Lubbock, TX 79411-1524

Call (806) 780-8300 Map

Fax (806) 780-8383

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400XNone listed

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

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About NPI 1982114344

Jackie Jerome Johnson Sr., LCDC-I's National Provider Identifier is 1982114344, issued on Oct 11, 2017. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Lubbock, TX. The record was last updated on Oct 11, 2017.