Jacqueline Nicole Jackson, BSPM/BA/MSFP
Counselor, Mental Health in Guyton, GA. Individual provider (NPI-1).
NPI number1629935978
StatusActive
Last updated in NPPESJan 8, 2026
Details
- NPI
- 1629935978
- Entity type
- Individual (NPI-1)
- Name
- Jacqueline Nicole Jackson
- Credential
- BSPM/BA/MSFP
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jan 8, 2026
- Certification date
- Jan 8, 2026
- Last updated
- Jan 8, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YM0800X | Counselor, Mental Health | – | – | Yes |
| 101Y00000X | Counselor | – | – | |
| 261QM0801X | Clinic/Center, Mental Health (Including Community Mental Health Center) | – | – |
Practice location
174 Scholar RdGuyton, GA 31312-6240
Phone 912-231-7061
Mailing address
174 Scholar RdGuyton, GA 31312-6240
Phone 912-231-7061
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