| Heather Jackson, Ms, Lmhc, Llc | |
|
256 Carson Oaks Ln Santa Rosa Beach FL 32459-7149 | |
| (850) 974-1793 | |
| Not Available |
| Full Name | Heather Jackson, Ms, Lmhc, Llc |
|---|---|
| Speciality | Counselor |
| Location | 256 Carson Oaks Ln, Santa Rosa Beach, Florida |
| Authorized Official Name and Position | Heather Jackson (PRESIDENT) |
| Authorized Official Contact | 8509741793 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Heather Jackson, Ms, Lmhc, Llc 256 Carson Oaks Ln Santa Rosa Beach FL 32459-7149 Ph: () - | Heather Jackson, Ms, Lmhc, Llc 256 Carson Oaks Ln Santa Rosa Beach FL 32459-7149 Ph: (850) 974-1793 |
| NPI Number | 1013364132 |
|---|---|
| Provider Enumeration Date | 05/18/2016 |
| Last Update Date | 05/18/2016 |
| Medicare PECOS PAC ID | 7911341086 |
|---|---|
| Medicare Enrollment ID | O20240216000591 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013364132 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | MH 14095 (Florida) | Primary |
| Provider Name | Heather Jackson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1053768176 PECOS PAC ID: 8820432990 Enrollment ID: I20240216000782 |
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