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

Antoine Deshawn Jackson, MA, LPCC

Individual provider Mental Health Counselor · NPI 1174278048

Antoine Deshawn Jackson, MA, LPCC is a Mental Health Counselor in Roseville, Minnesota. Practices as a sole proprietor. Licensed in Minnesota.

Licensed in
MN
In the registry since
2022
What do these letters mean?
MA — Master of Arts
A graduate arts degree.
LPCC — Licensed Professional Clinical Counselor
The title some states use for a licensed clinical counsellor.

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Practice location Address checks out

2335 Woodbridge St Apt 338
Roseville, MN 55113-4763
Phone: (612) 715-4071
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X · Licence 3145 (MN)

Record details

NPI number1174278048
Entity typeIndividual (Type 1)
GenderMale
Credentials MA , LPCC
Sole proprietorYes
NPI enumeratedFebruary 18, 2022
Last updated in NPPESNovember 14, 2024
Certification dateNovember 14, 2024

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