Jackson Counseling Services Llc | |
806 Hogsback Rd Ste C Mason MI 48854-8525 | |
(734) 658-1552 | |
Not Available |
Full Name | Jackson Counseling Services Llc |
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Speciality | Social Worker |
Location | 806 Hogsback Rd Ste C, Mason, Michigan |
Authorized Official Name and Position | Mary Beth Houpt (CREDENTIALING) |
Authorized Official Contact | 5176769797 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Jackson Counseling Services Llc Po Box 10 Mason MI 48854-0010 Ph: (517) 676-9788 | Jackson Counseling Services Llc 806 Hogsback Rd Ste C Mason MI 48854-8525 Ph: (734) 658-1552 |
NPI Number | 1326773656 |
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Provider Enumeration Date | 07/20/2022 |
Last Update Date | 09/23/2022 |
Certification Date | 09/15/2022 |
Medicare PECOS PAC ID | 4789050956 |
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Medicare Enrollment ID | O20221013002238 |
Identifier | Type | State | Issuer |
---|---|---|---|
1326773656 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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104100000X | Social Worker | (* (Not Available)) | Primary |
261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Secondary |
Provider Name | Rebecca Lynn Jackson |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1306329313 PECOS PAC ID: 5698141869 Enrollment ID: I20221013002319 |
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