Mary Jackson, LPC-22257
Mary Jackson, LPC-22257 is an Undefined Non-Physician Type (Specify) in Payson, Arizona. Qualified in 2015, 11 years ago. Practices with Southwest Behavioral Health Services Inc, a 48-clinician group. Licensed in Arizona.
- Years since qualifying
- 11
- Licensed in
- AZ
- In the registry since
- 2023
Practice location Address checks out
404 W Aero DrPayson, AZ 85541-5407
Phone: (928) 474-3303
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Specialties & licences
| Professional Counselor (primary) | Taxonomy 101YP2500X · Licence LPC-22257 (AZ) |
|---|
Record details
| NPI number | 1881374684 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Credentials | LPC-22257 |
| Sole proprietor | No |
| NPI enumerated | July 18, 2023 |
| Last updated in NPPES | July 18, 2023 |
| Certification date | July 18, 2023 |
Medicare enrollment
| Medicare specialty | UNDEFINED NON-PHYSICIAN TYPE (SPECIFY) |
|---|---|
| Medical school | OTHER |
| Graduated | 2015 (11 years in practice) |
| Group practice | Southwest Behavioral Health Services Inc — 48 clinicians |
| Accepts Medicare assignment | Not indicated |
Other providers in Payson
-
Lori Lynn Davenport, LPC
901 E Park Dr, Payson, AZ 85541-4442 · (928) 970-1027
-
William Neal
404 W Aero Dr, Payson, AZ 85541-5407 · (928) 474-3303