ORVILLE JACKSON NPI 1568123248

NPI Information

NPI: 1568123248
Provider Name: ORVILLE JACKSON
Classification: Counselor - 101YM0800X
Entity Type: Individual

Specialization: Mental Health

Address:
5556 REDAN RD
STONE MOUNTAIN, GA
ZIP 30088
Phone: (404) 585-7533
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Orville Jackson is a mental health counselor in Stone Mountain, GA. Orville Jackson NPI is 1568123248. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

5556 REDAN RD
STONE MOUNTAIN, GA
ZIP 30088-204
Phone: (404) 585-7533

The enumeration date for this NPI number is 1/5/2022 and was last updated on 1/5/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YM0800X	Counselor	Mental Health			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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