Doctor Name: | KIMBERLY ANN JACKSON |
NPI Number: | 1396159216 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPCC |
License Number: | 0013863 |
Business Practice Address: | 36 S 18th Ave Ste D3 Brighton, CO - 806012452 |
Business Phone Number: | 5032500510 |
Business Fax Number: | |
Mailing Address: | 16587 Leyden St, BRIGHTON |
State: | CO |
Postal Code: | 806026058 |
Phone Number: | 5032500510 |
Fax Number: | |
NPI Enumeration Date: | 06/18/2014 |
NPI Last Update Date: | 06/18/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | 0013863 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CO |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |