Sandra Jean Jackson, MS,LPC

Individual provider Active NPI Professional Counselor · Locust Grove, VA

NPI 1104771971 · NPPES record last updated Feb 26, 2026

Key facts

NPI
1104771971
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
0701007814 (VA)
Practice address
35060 Rogers Way
Locust Grove, VA 22508-5404
Phone
(703) 987-8351
NPI assigned
Feb 26, 2026
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
0701007814VAMDProfessional Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor
Group: 193400000X SINGLE SPECIALTY GROUP
101YP2500X 0701007814 VA Yes

Addresses

Primary practice location

35060 Rogers Way
Locust Grove, VA 22508-5404

Mailing address

35060 Rogers Way
Locust Grove, VA 22508-5404
Phone (703) 987-8351

Other providers in Locust Grove, VA

All providers in Locust Grove, VA · Professional Counselor in Virginia

Sources for this page

Verify at the official NPI Registry.