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Jan Jackson
Mental Health Counselor in Sun Prairie, Wisconsin
NPI 1871535047

Jan Jackson is a Mental Health Counselor based in Stoughton, WI and is specialized in Mental Health. Jan Jackson practices in Sun Prairie, WI. The NPI Number for Jan Jackson is 1871535047 and holds a License No. 1315 (Wisconsin).

The current practice location address for Jan Jackson is 1460 W Main St, Sun Prairie, WI and can be reached out via phone at 608-837-4814.

Location: 1460 W Main St, Sun Prairie, WI, 53589-4237
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1871535047
Provider Name
Jan Jackson
Credential
Provider Entity Type
Individual
Gender
Male
Address
1460 W Main St, Sun Prairie, WI, 53589-4237
Phone Number
608-837-4814
Fax Number
Provider Enumeration Date
06/12/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
39118400 05 WI
institution
Provider Business Practice Location Address Details
Address
1460 W Main St
City
Sun Prairie
State
Wisconsin
Zip
53590-1846
Phone Number
608-837-4814
Fax Number
person
Provider Business Mailing Address Details
Address
1460 W Main St
City
Sun Prairie
State
Wisconsin
Zip
53590-1846
Phone Number
608-837-4814
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
101YA0400X
License No.
2519 (Wisconsin)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
1315 (Wisconsin)
Definition
Definition to come...
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