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

Ortagus Davour Jackson, CERTIFICATE

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1376491258

Ortagus Davour Jackson, CERTIFICATE is an Addiction (Substance Use Disorder) Counselor in Detroit, Michigan. Practices as a sole proprietor. Licensed in Michigan.

Licensed in
MI
In the registry since
2026

Practice location Address checks out

18939 Schoenherr St
Detroit, MI 48205-2205
Phone: (313) 300-7599
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 · Licence 172V00000X (MI)

Record details

NPI number1376491258
Entity typeIndividual (Type 1)
GenderMale
Credentials CERTIFICATE
Sole proprietorYes
NPI enumeratedMarch 18, 2026
Last updated in NPPESMarch 24, 2026
Certification dateMarch 24, 2026

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