KEVIA CONTRELLE JACKSON LPC NPI 1619552890

NPI Information

NPI: 1619552890
Provider Name: KEVIA CONTRELLE JACKSON, LPC
Classification: Counselor - 101YM0800X
Entity Type: Individual

Specialization: Mental Health

Address:
1670 CLAIRMONT RD
DECATUR, GA
ZIP 30033
Phone: (404) 321-6111
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Kevia Contrelle Jackson, LPC is a mental health counselor in Decatur, GA. Kevia Contrelle Jackson, LPC NPI is 1619552890. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1670 CLAIRMONT RD
DECATUR, GA
ZIP 30033-004
Phone: (404) 321-6111

The enumeration date for this NPI number is 3/10/2021 and was last updated on 11/4/2022.

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	101YP2500X	Counselor	Professional			No
2	101YM0800X	Counselor	Mental Health	LPC011309	GEORGIA	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: 4/28/2024

NPI Synchronization or Removal

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