| Doctor Name: | MS. CINDY SHELLY ANN JACKSON |
| NPI Number: | 1588922553 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCSW |
| License Number: | 5580-C |
| Business Practice Address: | 5135 Camino Al Norte Suite 279 N. Las Vegas, NV - 890312373 |
| Business Phone Number: | 7028536708 |
| Business Fax Number: | 7028536709 |
| Mailing Address: | 5135 Camino Al Norte Ste 279, N. LAS VEGAS |
| State: | NV |
| Postal Code: | 890842373 |
| Phone Number: | 7028536708 |
| Fax Number: | 7028536709 |
| NPI Enumeration Date: | 04/27/2012 |
| NPI Last Update Date: | 12/26/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 5580-C |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NV |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |