CHARLES JACKSON NPI 1457896839

NPI Information

NPI: 1457896839
Provider Name: CHARLES JACKSON
Classification: Counselor - 101YM0800X
Entity Type: Individual

Specialization: Mental Health

Address:
2911 PENICK ST
SHREVEPORT, LA
ZIP 71109
Phone: (318) 393-8396
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Charles Jackson is a mental health counselor in Shreveport, LA. Charles Jackson NPI is 1457896839. 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:

2911 PENICK ST
SHREVEPORT, LA
ZIP 71109-337
Phone: (318) 393-8396

The enumeration date for this NPI number is 12/21/2016 and was last updated on 12/21/2016.

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		LOUISIANA	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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