Jackson, Charissa

Jackson, Charissa is an individual health care provider with primary practice located at 6601 W 12Th St , Little Rock AR 72204-1513. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counselor, Behavioral Health & Social Service Providers / Social Worker. Behavioral Health & Social Service Providers / Social Worker is her primary health care specialty. Jackson, Charissa can be contacted via phone (501) 666-8686.

Contact Information

Primary practice address
6601 W 12Th St Little Rock AR 72204-1513
Phone: (501) 666-8686
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counselor 101Y00000X
Behavioral Health & Social Service Providers / Social Worker 104100000X

Profile Details

NPI number 1184031445
LBN Legal business name Jackson, Charissa
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 18th, 2014
Last updated Jul 18th, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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