MR. Leon Tremain Jackson, EDS, MS, NCC, LPC

NPI #1699141531 in Vicksburg, Mississippi

Provider Information

NPI Number: 1699141531
Entity Type: Individual
Name: MR. Leon Tremain Jackson, EDS, MS, NCC, LPC
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Counselor
Credential: EDS, MS, NCC, LPC
Enumeration Date: Aug 14, 2015
Last Updated: Aug 14, 2015

Practice Location

Address: 1115B OPENWOOD ST
City: Vicksburg
State: Mississippi
ZIP Code: 39183-2533
Phone: (318) 341-2202

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor	101Y00000X	Primary
Counselor - Addiction (Substance Use Disorder) — Addiction (Substance Use Disorder)	101YA0400X
Counselor - Mental Health — Mental Health	101YM0800X
Counselor - Professional — Professional	101YP2500X
Marriage & Family Therapist	106H00000X

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