Jackson Psychotherapy, LLC

NPI #1154846533 in Lawrence, Kansas

Provider Information

NPI Number: 1154846533
Entity Type: Organization
Organization Name: Jackson Psychotherapy, LLC
Primary Specialty: Social Worker - Clinical
Enumeration Date: Aug 7, 2017
Last Updated: Jul 21, 2022

Practice Location

Address: 901 KENTUCKY ST STE 306
City: Lawrence
State: Kansas
ZIP Code: 66044-2858
Phone: (816) 377-7398

Authorized Official

Name: REGINALD C. JACKSON, LSCSW, LCSW
Title: OWNER/EXECUTIVE DIRECTOR
Phone: (816) 377-7398

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Social Worker - Clinical — Clinical	1041C0700X	Primary

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