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Antionette Marie Jackson
Mental Health Counselor in Crawfordville, Florida
NPI 1649864885

Antionette Marie Jackson is a Mental Health Counselor based in Midway, FL and is specialized in Mental Health. Antionette Marie Jackson practices in Crawfordville, FL. The NPI Number for Antionette Marie Jackson is 1649864885 and holds a License No. (Florida).

The current practice location address for Antionette Marie Jackson is 110 Melaleuca Dr, Crawfordville, FL and can be reached out via phone at 850-617-9167.

Location: 110 Melaleuca Dr, Crawfordville, FL, 32343-4293
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1649864885
Provider Name
Antionette Marie Jackson
Credential
Provider Entity Type
Individual
Gender
Female
Address
110 Melaleuca Dr, Crawfordville, FL, 32343-4293
Phone Number
850-617-9167
Fax Number
Provider Enumeration Date
03/01/2021
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
110 Melaleuca Dr
City
Crawfordville
State
Florida
Zip
32327-4963
Phone Number
850-617-9167
Fax Number
person
Provider Business Mailing Address Details
Address
110 Melaleuca Dr
City
Crawfordville
State
Florida
Zip
32327-4963
Phone Number
850-617-9167
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
-
Taxonomy
101Y00000X
License No.
()
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.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 3
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Professional
Taxonomy
101YP2500X
License No.
()
Definition
Definition to come...
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