person
Joseph Granville Jackson, CCS,RAC
Addiction (Substance Use Disorder) Counselor in Lake Providence, Louisiana
NPI 1891152773

Joseph Granville Jackson is an Addiction (Substance Use Disorder) Counselor based in Lake Providence, LA and is specialized in Addiction (Substance Use Disorder). Joseph Granville Jackson practices in Lake Providence, LA and has the professional credentials of CCS,RAC. The NPI Number for Joseph Granville Jackson is 1891152773 and holds a License No. 186 (Louisiana).

The current practice location address for Joseph Granville Jackson is 411 Sparrow St, Lake Providence, LA and can be reached out via phone at 318-559-3356 and via fax at 318-559-2044.

Location: 411 Sparrow St, Lake Providence, LA, 71254-3520
person
Provider Profile Details
NPI Number
1891152773
Provider Name
Joseph Granville Jackson
Credential
CCS,RAC
Provider Entity Type
Individual
Gender
Male
Address
411 Sparrow St, Lake Providence, LA, 71254-3520
Phone Number
318-559-3356
Fax Number
318-559-2044
Provider Enumeration Date
01/22/2016
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
411 Sparrow St
City
State
Zip
71254-3035
Phone Number
318-559-3356
Fax Number
318-559-2044
person
Provider Business Mailing Address Details
Address
411 Sparrow St
City
State
Zip
71254-3035
Phone Number
318-559-3356
Fax Number
318-559-2044
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
186 (Louisiana)
Definition
Definition to come...
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