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

Jackson Lake, LAC

Individual provider Mental Health Counselor · NPI 1720763717

Jackson Lake, LAC is a Mental Health Counselor in Little Rock, Arkansas. Practices as a sole proprietor. Licensed in Arkansas.

Licensed in
AR
In the registry since
2023
What do these letters mean?
LAC — Licensed Associate Counselor
A counsellor practising under supervision toward full licensure. In some states the same letters mean Licensed Acupuncturist.

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Practice location Address checks out

10020 N Rodney Parham Rd Ste G
Little Rock, AR 72227-5588
Phone: (501) 831-4314
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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 A2305013 (AR)

Record details

NPI number1720763717
Entity typeIndividual (Type 1)
GenderMale
Credentials LAC
Sole proprietorYes
NPI enumeratedJune 19, 2023
Last updated in NPPESJune 19, 2023
Certification dateJune 19, 2023

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