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

Cornell Demetrius Jackson Sr., MSMENTALHEALTH

Individual provider Mental Health Counselor · NPI 1215667373

Cornell Demetrius Jackson Sr., MSMENTALHEALTH is a Mental Health Counselor in Alton, Illinois. Registered with an NPI since 2022.

In the registry since
2022

Practice location Address checks out

2615 Edwards St
Alton, IL 62002-3915
Phone: (730) 274-0085
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X

Record details

NPI number1215667373
Entity typeIndividual (Type 1)
GenderMale
Credentials MSMENTALHEALTH
Sole proprietorNo
NPI enumeratedJune 13, 2022
Last updated in NPPESMarch 25, 2026
Certification dateMarch 25, 2026

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