Queysheina Jackson

Individual provider Active NPI Mental Health Counselor · Reserve, LA

NPI 1780242693 · NPPES record last updated Jun 5, 2019

Key facts

NPI
1780242693
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
Practice address
215 Homewood PL
Reserve, LA 70084-5525
Phone
(985) 212-2002
NPI assigned
Jun 5, 2019
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

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Yes

Addresses

Primary practice location

215 Homewood PL
Reserve, LA 70084-5525

Mailing address

215 Homewood PL
Reserve, LA 70084-5525
Phone (985) 212-2002

Other providers in Reserve, LA

All providers in Reserve, LA · Mental Health Counselor in Louisiana

Sources for this page

Verify at the official NPI Registry.