Desralei Jackson, LCSW,ACSW
Social Worker, Clinical in Charleston, SC. Individual provider (NPI-1).
NPI number1245249804
StatusActive
Last updated in NPPESAug 14, 2020
Details
- NPI
- 1245249804
- Entity type
- Individual (NPI-1)
- Name
- Desralei Jackson
- Credential
- LCSW,ACSW
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Aug 5, 2006
- Certification date
- Aug 14, 2020
- Last updated
- Aug 14, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | 8989 | SC | Yes |
| 1041C0700X | Social Worker, Clinical | 21261 | TX |
Practice location
109 Bee StCharleston, SC 29401-5703
Phone 843-789-6326
Mailing address
109 Bee StCharleston, SC 29401-5703
Phone 843-789-6326
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