| Jackson Counseling Services Llc | |
|
806 Hogsback Rd Ste C Mason MI 48854-8525 | |
| (734) 658-1552 | |
| Not Available |
| Full Name | Jackson Counseling Services Llc |
|---|---|
| Speciality | Social Worker |
| Location | 806 Hogsback Rd Ste C, Mason, Michigan |
| Authorized Official Name and Position | Mary Beth Houpt (CREDENTIALING) |
| Authorized Official Contact | 5176769797 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jackson Counseling Services Llc Po Box 10 Mason MI 48854-0010 Ph: (517) 676-9788 | Jackson Counseling Services Llc 806 Hogsback Rd Ste C Mason MI 48854-8525 Ph: (734) 658-1552 |
| NPI Number | 1326773656 |
|---|---|
| Provider Enumeration Date | 07/20/2022 |
| Last Update Date | 09/23/2022 |
| Certification Date | 09/15/2022 |
| Medicare PECOS PAC ID | 4789050956 |
|---|---|
| Medicare Enrollment ID | O20221013002238 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326773656 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | (* (Not Available)) | Primary |
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Secondary |
| Provider Name | Rebecca Lynn Jackson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306329313 PECOS PAC ID: 5698141869 Enrollment ID: I20221013002319 |
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