Active NPIIndividual providerSole proprietor

Melissa Jackson, LAC

Counselor, Mental Health in Brick, New Jersey

NPI Number1114673381
Practice location
220 Jack Martin Blvd # E2, Brick, NJ 08724-7772
Fax
—
Last updated
February 26, 2022

Melissa Jackson is a Counselor, Mental Health based in Brick, NJ. Melissa Jackson practices in Brick, NJ and has the professional credentials of LAC. The NPI Number for Melissa Jackson is 1114673381 and holds a License No. 37AC00133700 (NJ). The current practice location address for Melissa Jackson is 220 Jack Martin Blvd # E2, Brick, NJ 08724-7772 and can be reached out via phone at 732-920-3434.

Provider Profile Details

NPI Number
1114673381
Provider Name
Melissa Jackson
Credential
LAC
Provider Entity Type
Individual
Gender
Female
Address
220 Jack Martin Blvd # E2, Brick, NJ 08724-7772
Phone Number
732-920-3434
Primary Taxonomy
Counselor, Mental Health · 101YM0800X
Sole Proprietor
Yes
Provider Enumeration Date
February 26, 2022
Last Update Date
February 26, 2022
Certification Date
February 26, 2022
NPI Status
Active

Provider Business Practice Location Address Details

Address
220 Jack Martin Blvd # E2
Brick, NJ 08724-7772
City
Brick
Zip
08724-7772
Phone Number
732-920-3434
Brick, NJ 08724Get directions →

Provider Business Mailing Address Details

Address
220 Jack Martin Blvd # E2
Brick, NJ 08724-7772
City
Brick
State
NJ
Zip
08724-7772
Phone Number
732-239-3427

License Information

License Number
37AC00133700
License State
NJ
Taxonomy
Counselor, Mental Health · 101YM0800X · Primary

Legacy Identifiers

IdentifierTypeStateIssuer
No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider.

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Frequently Asked Questions

What is the NPI number of Melissa Jackson, LAC?

The NPI number of Melissa Jackson, LAC is 1114673381. It was assigned on February 26, 2022 and is currently active in the NPPES registry.

What is the specialty of Melissa Jackson, LAC?

Melissa Jackson, LAC is registered under the primary taxonomy Counselor, Mental Health (code 101YM0800X), licensed in NJ under license number 37AC00133700.

Where does Melissa Jackson, LAC practice?

The practice location is 220 Jack Martin Blvd # E2, Brick, NJ 08724-7772. The office can be reached at 732-920-3434 (phone).

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.

How do I verify this NPI record?

This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1114673381 directly on the NPPES registry website.

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