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Mrs. Shannon Marie Jackson
Counselor in La Mesa, California
NPI 1558742395

Shannon Marie Jackson is a Counselor based in La Mesa, CA. Shannon Marie Jackson practices in La Mesa, CA. The NPI Number for Shannon Marie Jackson is 1558742395 and holds a License No. LPCC658 (California).

The current practice location address for Shannon Marie Jackson is 4990 Williams Ave, La Mesa, CA and can be reached out via phone at 619-668-4265 and via fax at 619-668-4264.

Location: 4990 Williams Ave, La Mesa, CA, 91942-7409
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1558742395
Provider Name
Shannon Marie Jackson
Credential
Provider Entity Type
Individual
Gender
Female
Address
4990 Williams Ave, La Mesa, CA, 91942-7409
Phone Number
619-668-4265
Fax Number
619-668-4264
Provider Enumeration Date
06/17/2015
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
LPCC658 01 CA BBS
institution
Provider Business Practice Location Address Details
Address
4990 Williams Ave
City
La Mesa
State
California
Zip
91942-7409
Phone Number
619-668-4265
Fax Number
619-668-4264
person
Provider Business Mailing Address Details
Address
4990 Williams Ave
City
La Mesa
State
California
Zip
91942-7409
Phone Number
619-668-4265
Fax Number
619-668-4264
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
-
Taxonomy
101Y00000X
License No.
LPCC658 (California)
Definition
A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.
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