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James Jackson
Mental Health Counselor in Lake Providence, Louisiana
NPI 1417406380

James Jackson is a Mental Health Counselor based in Lake Providence, LA and is specialized in Mental Health. James Jackson practices in Lake Providence, LA. The NPI Number for James Jackson is 1417406380 and holds a License No. (Louisiana).

The current practice location address for James Jackson is 1700 Lake St, Lake Providence, LA and can be reached out via phone at 318-559-0551.

Location: 1700 Lake St, Lake Providence, LA, 71254-5208
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1417406380
Provider Name
James Jackson
Credential
Provider Entity Type
Individual
Gender
Male
Address
1700 Lake St, Lake Providence, LA, 71254-5208
Phone Number
318-559-0551
Fax Number
Provider Enumeration Date
10/03/2016
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
1700 Lake St
City
Lake Providence
State
Louisiana
Zip
71254-5208
Phone Number
318-559-0551
Fax Number
person
Provider Business Mailing Address Details
Address
1700 Lake St
City
Lake Providence
State
Louisiana
Zip
71254-5208
Phone Number
318-559-0551
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
(Louisiana)
Definition
Definition to come...
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