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Sam Jackson, LAC
Counselor in Mesa, Arizona
NPI 1851750061

Sam Jackson is a Counselor based in Mesa, AZ. Sam Jackson practices in Mesa, AZ and has the professional credentials of LAC. The NPI Number for Sam Jackson is 1851750061 and holds a License No. LAC-15314 (Arizona).

The current practice location address for Sam Jackson is 4250 E Florian Ave, Mesa, AZ and can be reached out via phone at 480-844-1653.

Location: 4250 E Florian Ave, Mesa, AZ, 85201-4108
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1851750061
Provider Name
Sam Jackson
Credential
LAC
Provider Entity Type
Individual
Gender
Male
Address
4250 E Florian Ave, Mesa, AZ, 85201-4108
Phone Number
480-844-1653
Fax Number
Provider Enumeration Date
02/16/2016
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
4250 E Florian Ave
City
Mesa
State
Arizona
Zip
85206-2797
Phone Number
480-844-1653
Fax Number
person
Provider Business Mailing Address Details
Address
4250 E Florian Ave
City
Mesa
State
Arizona
Zip
85206-2797
Phone Number
480-844-1653
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
-
Taxonomy
101Y00000X
License No.
LAC-15314 (Arizona)
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.
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