| Shane Michell Jackson, LPC | |
|
115 W Tyler St, Gilmer, TX 75644-2239 | |
| (903) 746-7643 | |
| (903) 843-4336 |
| Full Name | Shane Michell Jackson |
|---|---|
| Gender | Female |
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 115 W Tyler St, Gilmer, Texas |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922173897 | NPI | - | NPPES |
| 16480 | Other | TX | LPC |
| 4128 | Other | TX | LCDC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 4128 (Texas) | Primary |
| 101YM0800X | Counselor - Mental Health | 16480 (Texas) | Secondary |
| Mailing Address | Practice Location Address |
|---|---|
| Shane Michell Jackson, LPC Po Box 1551, Gilmer, TX 75644-1551 Ph: (903) 746-7643 | Shane Michell Jackson, LPC 115 W Tyler St, Gilmer, TX 75644-2239 Ph: (903) 746-7643 |
Wanda Marie Kennel, LCDC, LSBW Counselor Medicare: Not Enrolled in Medicare Practice Location: 6563 Highland Rd, Gilmer, TX 75645 Phone: 903-734-5592 | |
Barbara Lea Schovanec, L.P.C. Counselor Medicare: Not Enrolled in Medicare Practice Location: 703 Titus St, Gilmer, TX 75644 Phone: 903-843-5529 | |
Leah Erickson, M.ED, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 104 N Montgomery St, Gilmer, TX 75644 Phone: 903-918-1888 | |
Mrs. Kristen E Boyer, LPC-ASSOCIATE Counselor Medicare: Not Enrolled in Medicare Practice Location: 5468 Locust Rd, Gilmer, TX 75645 Phone: 903-833-6443 |