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Phoenix Jackson
Mental Health Counselor in San Rafael, California
NPI 1619349933

Phoenix Jackson is a Mental Health Counselor based in San Rafael, CA and is specialized in Mental Health. Phoenix Jackson practices in San Rafael, CA. The NPI Number for Phoenix Jackson is 1619349933 and holds a License No. 91873 (California).

The current practice location address for Phoenix Jackson is 1 Saint Vincents Dr, San Rafael, CA and can be reached out via phone at 415-610-1768.

Location: 1 Saint Vincents Dr, San Rafael, CA, 94903-1504
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1619349933
Provider Name
Phoenix Jackson
Credential
Provider Entity Type
Individual
Gender
Female
Address
1 Saint Vincents Dr, San Rafael, CA, 94903-1504
Phone Number
415-610-1768
Fax Number
Provider Enumeration Date
10/26/2015
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
1 Saint Vincents Dr
City
San Rafael
State
California
Zip
94903-1504
Phone Number
415-610-1768
Fax Number
person
Provider Business Mailing Address Details
Address
1 Saint Vincents Dr
City
San Rafael
State
California
Zip
94903-1504
Phone Number
415-610-1768
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
-
Taxonomy
101Y00000X
License No.
91873 (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.
person
Provider's Taxonomy Details 2
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
91873 (California)
Definition
Definition to come...
person
Provider's Taxonomy Details 3
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
School
Taxonomy
101YS0200X
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 4
Type
Behavioral Health & Social Service Providers
Classification
Marriage & Family Therapist
Speciality
-
Taxonomy
106H00000X
License No.
()
Definition
A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups.
person
Provider's Taxonomy Details 5
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
91873 (California)
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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