person
Ms. Ida B Jackson, LCPC,
Mental Health Counselor in Chicago, Illinois
NPI 1659682037

Ida B Jackson is a Mental Health Counselor based in Chicago, IL and is specialized in Mental Health. Ida B Jackson practices in Chicago, IL and has the professional credentials of LCPC,. The NPI Number for Ida B Jackson is 1659682037 and holds a License No. 180-000225 (Illinois).

The current practice location address for Ida B Jackson is 4314 S Cottage Grove Ave, Chicago, IL and can be reached out via phone at 312-747-0036 and via fax at 312-747-2208.

Location: 4314 S Cottage Grove Ave, Chicago, IL, 60653-3514
person
Provider Profile Details
NPI Number
1659682037
Provider Name
Ida B Jackson
Credential
LCPC,
Provider Entity Type
Individual
Gender
Female
Address
4314 S Cottage Grove Ave, Chicago, IL, 60653-3514
Phone Number
312-747-0036
Fax Number
312-747-2208
Provider Enumeration Date
06/30/2010
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
4314 S Cottage Grove Ave
City
State
Zip
60653-3514
Phone Number
312-747-0036
Fax Number
312-747-2208
person
Provider Business Mailing Address Details
Address
4314 S Cottage Grove Ave
City
State
Zip
60653-3514
Phone Number
312-747-0036
Fax Number
312-747-2208
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
License No.
180-000225 (Illinois)
Definition
Definition to come...
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