Jackson, Sherry A

Jackson, Sherry A is an individual health care provider with primary practice located at 12849 Galveston Ct # 120 , Manassas VA 20112-8676. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder). Behavioral Health & Social Service Providers / Professional is her primary health care specialty. Jackson, Sherry A can be contacted via phone (571) 545-0592.

Contact Information

Primary practice address
12849 Galveston Ct # 120 Manassas VA 20112-8676
Phone: (571) 545-0592
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X
Behavioral Health & Social Service Providers / Professional 101YP2500X 0701005445 Virginia
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X

Profile Details

NPI number 1902232333
LBN Legal business name Jackson, Sherry A
Credentials Licensed Professional Counselor (LPC)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 17th, 2013
Last updated Jan 13th, 2025 - about last year

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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Identifiers

StateTypeNumberIssuer
All States NPI 1902232333 NPPES
Virginia MEDICAID 04945247

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