Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jackson Professional Serv LLC

Organization Addiction (Substance Use Disorder) Counselor · NPI 1922761352

Jackson Professional Serv LLC is an Addiction (Substance Use Disorder) Counselor in Petersburg, Virginia. Registered with an NPI since 2021.

In the registry since
2021
Specialties on file
5
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

420 Pine Ridge Rd
Petersburg, VA 23805-1320
Phone: (804) 714-5998
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Addiction (Substance Use Disorder) Counselor (primary) Taxonomy 101YA0400X
Mental Health Counselor Taxonomy 101YM0800X
Community Health Worker Taxonomy 172V00000X
Community/Behavioral Health Agency Taxonomy 251S00000X
Adolescent and Children Mental Health Clinic/Center Taxonomy 261QM0855X

Record details

NPI number1922761352
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Antoinita Stokes — Consultant · (804) 613-0087
Other names Valecia Jackson
NPI enumeratedOctober 21, 2021
Last updated in NPPESOctober 21, 2021
Certification dateOctober 21, 2021
Mailing address420 Pine Ridge Rd, Petersburg, VA 23805-1320

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