Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Stacie Jackson

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1073292306

Stacie Jackson is an Addiction (Substance Use Disorder) Counselor in Covina, California. Licensed in California. Registered with an NPI since 2023.

Licensed in
CA
In the registry since
2023
Specialties on file
2

Practice location Address checks out

1274 Center Court Dr Ste 211
Covina, CA 91724-3668
Phone: (626) 339-4999
Show map & directions

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

Specialties & licences

Behavior Technician (primary) Taxonomy 106S00000X (CA)
Addiction (Substance Use Disorder) Counselor Taxonomy 101YA0400X · Licence R1494190123 (CA)

Record details

NPI number1073292306
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJuly 13, 2023
Last updated in NPPESOctober 1, 2026
Certification dateOctober 1, 2026

Other providers in Covina