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Minna R Jackson, LPC
Professional Counselor in Blacksburg, Virginia
NPI 1013034362

Minna R Jackson is a Professional Counselor based in Blacksburg, VA and is specialized in Professional. Minna R Jackson practices in Blacksburg, VA and has the professional credentials of LPC. The NPI Number for Minna R Jackson is 1013034362 and holds a License No. 0701003660 (Virginia).

The current practice location address for Minna R Jackson is 100 Ardmore St Ste 304, Blacksburg, VA and can be reached out via phone at 276-613-4273.

Location: 100 Ardmore St Ste 304, Blacksburg, VA, 24060-5555
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1013034362
Provider Name
Minna R Jackson
Credential
LPC
Provider Entity Type
Individual
Gender
Female
Address
100 Ardmore St Ste 304, Blacksburg, VA, 24060-5555
Phone Number
276-613-4273
Fax Number
Provider Enumeration Date
03/23/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
004945298 05 VA
institution
Provider Business Practice Location Address Details
Address
100 Ardmore St Ste 304
City
Blacksburg
State
Virginia
Zip
24060-5802
Phone Number
276-613-4273
Fax Number
person
Provider Business Mailing Address Details
Address
100 Ardmore St Ste 304
City
Blacksburg
State
Virginia
Zip
24060-5802
Phone Number
276-613-4273
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Professional
Taxonomy
101YP2500X
License No.
0701003660 (Virginia)
Definition
Definition to come...
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