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

Mr. Cornell Lee Jackson

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1851630461

Mr. Cornell Lee Jackson is an Addiction (Substance Use Disorder) Counselor in Detroit, Michigan. Practices as a sole proprietor. Registered with an NPI since 2013.

In the registry since
2013

Practice location Address checks out

1852 W Grand Blvd
Detroit, MI 48208-1006
Phone: (313) 894-8444
Fax: (313) 894-5542
Show map & directions

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

Specialties & licences

Addiction (Substance Use Disorder) Counselor (primary) Taxonomy 101YA0400X

Record details

NPI number1851630461
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedFebruary 4, 2013
Last updated in NPPESFebruary 4, 2013

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