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Kevin D. Jackson
Peer Specialist in Yellow Springs, Ohio
NPI 1982376943

Kevin D. Jackson is a Peer Specialist based in Yellow Springs, OH. Kevin D. Jackson practices in Yellow Springs, OH. The NPI Number for Kevin D. Jackson is 1982376943 and holds a License No. 0002724 (Ohio).

The current practice location address for Kevin D. Jackson is 502 S High St Apt D, Yellow Springs, OH and can be reached out via phone at 937-287-5353.

Location: 502 S High St Apt D, Yellow Springs, OH, 45387-0751
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1982376943
Provider Name
Kevin D. Jackson
Credential
Provider Entity Type
Individual
Gender
Male
Address
502 S High St Apt D, Yellow Springs, OH, 45387-0751
Phone Number
937-287-5353
Fax Number
Provider Enumeration Date
09/29/2021
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
502 S High St Apt D
City
Yellow Springs
State
Ohio
Zip
45387-1565
Phone Number
937-287-5353
Fax Number
person
Provider Business Mailing Address Details
Address
502 S High St Apt D
City
Yellow Springs
State
Ohio
Zip
45387-1565
Phone Number
937-287-5353
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
175T00000X
License No.
0002724 (Ohio)
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
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