Jackson, Justin

Jackson, Justin is an individual health care provider with primary practice located at 4212 Park Place Ct , Glen Allen VA 23060-3314. He recently has 4 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counselor, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Professional is his primary health care specialty. Jackson, Justin can be contacted via phone (804) 332-5950.

Contact Information

Primary practice address
4212 Park Place Ct Glen Allen VA 23060-3314
Phone: (804) 332-5950
Fax: (804) 728-1086
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counselor 101Y00000X 0701008565 Virginia
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 0701008565 Virginia
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 0701008565 Virginia
Behavioral Health & Social Service Providers / Professional 101YP2500X 0701008565 Virginia

Profile Details

NPI number 1235788902
LBN Legal business name Jackson, Justin
Credentials Licensed Professional Counselor (LPC)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 5th, 2019
Last updated Aug 20th, 2021 - about 5 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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