person
Mr. Jerry Michael Jackson, MSW,ACSW
Mental Health Counselor in Bellevue, Washington
NPI 1699887166

Jerry Michael Jackson is a Mental Health Counselor based in Lake Forest Park, WA and is specialized in Mental Health. Jerry Michael Jackson practices in Bellevue, WA and has the professional credentials of MSW,ACSW. The NPI Number for Jerry Michael Jackson is 1699887166 and holds a License No. LW00004286 (Washington).

The current practice location address for Jerry Michael Jackson is 11016 Ne 2Nd Pl, Bellevue, WA and can be reached out via phone at 425-455-0348 and via fax at 206-367-0547. You can also correspond with Jerry Michael Jackson through the mailing address at 3723 NE 150TH ST, LAKE FOREST PARK, WA - 98155-7828 (mailing address contact number: 206-367-3351).

Location: 11016 Ne 2Nd Pl, Bellevue, WA, 98155-7828
person
Provider Profile Details
NPI Number
1699887166
Provider Name
Jerry Michael Jackson
Credential
MSW,ACSW
Provider Entity Type
Individual
Gender
Male
Address
11016 Ne 2Nd Pl, Bellevue, WA, 98155-7828
Phone Number
425-455-0348
Fax Number
206-367-0547
Provider Enumeration Date
08/31/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
LW00004286 01 WA LICENSED SOCIAL WORKER
institution
Provider Business Practice Location Address Details
Address
11016 Ne 2Nd Pl
City
State
Zip
98004-5830
Phone Number
425-455-0348
Fax Number
206-367-0547
person
Provider Business Mailing Address Details
Address
11016 Ne 2Nd Pl
City
State
Zip
98004-5830
Phone Number
425-455-0348
Fax Number
206-367-0547
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
License No.
LW00004286 (Washington)
Definition
Definition to come...
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