Search › Indiana › 101Y00000X
Mary Jackson, LCPC
NPI 1437456522 · on the registry since 2011 · sole proprietor
Practice
- Address
- 804 South Oakland Ave
Carbondale, IN 62901 - Phone
- (618) 203-3975
- Fax
- (618) 529-2182
Registry record
- Primary taxonomy
- 101Y00000X
101Y00000X
- Licence states on file
- IL
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2011-02-25
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Indiana