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Lavonne Jackson
Mental Health Counselor in Clearwater, Florida
NPI 1316576937

Lavonne Jackson is a Mental Health Counselor based in Clearwater, FL and is specialized in Mental Health. Lavonne Jackson practices in Clearwater, FL. The NPI Number for Lavonne Jackson is 1316576937 and holds a License No. 18659 (Florida).

The current practice location address for Lavonne Jackson is 622 S Betty Ln Apt 2, Clearwater, FL and can be reached out via phone at 757-769-9056.

Location: 622 S Betty Ln Apt 2, Clearwater, FL, 33758-7215
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1316576937
Provider Name
Lavonne Jackson
Credential
Provider Entity Type
Individual
Gender
Female
Address
622 S Betty Ln Apt 2, Clearwater, FL, 33758-7215
Phone Number
757-769-9056
Fax Number
Provider Enumeration Date
04/06/2020
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
18659 01 FL REGISTER MENTAL HEALTH COUNSELOR INTER
institution
Provider Business Practice Location Address Details
Address
622 S Betty Ln Apt 2
City
Clearwater
State
Florida
Zip
33756-6080
Phone Number
757-769-9056
Fax Number
person
Provider Business Mailing Address Details
Address
622 S Betty Ln Apt 2
City
Clearwater
State
Florida
Zip
33756-6080
Phone Number
757-769-9056
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
18659 (Florida)
Definition
Definition to come...
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