Krista Jackson, LCPC
Counselor, Professional in Lincolnshire, IL. Individual provider (NPI-1).
NPI number1265813596
StatusActive
Last updated in NPPESDec 13, 2023
Details
- NPI
- 1265813596
- Entity type
- Individual (NPI-1)
- Name
- Krista Jackson
- Credential
- LCPC
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jun 11, 2015
- Certification date
- Dec 13, 2023
- Last updated
- Dec 13, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YP2500X | Counselor, Professional | 180003226 | IL | Yes |
Practice location
111 Barclay Blvd Ste 180Lincolnshire, IL 60069-3615
Phone 847-748-2019 · Fax 847-748-2019
Mailing address
111 Barclay Blvd Ste 180Lincolnshire, IL 60069-3615
Phone 224-243-1472
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