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Mr. Glenn Jackson, LSW,LCPC,CMH
Mental Health Counselor in Olney, Illinois
NPI 1568833283

Glenn Jackson is a Mental Health Counselor based in Olney, IL and is specialized in Mental Health. Glenn Jackson practices in Olney, IL and has the professional credentials of LSW,LCPC,CMH. The NPI Number for Glenn Jackson is 1568833283 and holds a License No. (Illinois).

The current practice location address for Glenn Jackson is 504 Micah Dr, Olney, IL and can be reached out via phone at 618-395-4309 and via fax at 618-395-4507.

Location: 504 Micah Dr, Olney, IL, 62450-4720
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1568833283
Provider Name
Glenn Jackson
Credential
LSW,LCPC,CMH
Provider Entity Type
Individual
Gender
Male
Address
504 Micah Dr, Olney, IL, 62450-4720
Phone Number
618-395-4309
Fax Number
618-395-4507
Provider Enumeration Date
10/08/2015
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
180.000994 01 IL LICENSED CLINICAL PROFESSIONAL COUNSELOR
institution
Provider Business Practice Location Address Details
Address
504 Micah Dr
City
Olney
State
Illinois
Zip
62450-4720
Phone Number
618-395-4309
Fax Number
618-395-4507
person
Provider Business Mailing Address Details
Address
504 Micah Dr
City
Olney
State
Illinois
Zip
62450-4720
Phone Number
618-395-4309
Fax Number
618-395-4507
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
101YA0400X
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
()
Definition
Definition to come...
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