Provider Demographics
NPI:1306222013
Name:JANET E. JACKSON, SLPC & ASSOCIATES, LLC
Entity Type:Organization
Organization Name:JANET E. JACKSON, SLPC & ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:S-LPC
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANET
Authorized Official - Middle Name:E
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:MED
Authorized Official - Phone:205-271-2584
Mailing Address - Street 1:4268 CAHABA HEIGHTS CT
Mailing Address - Street 2:SUITE 190 C
Mailing Address - City:VESTAVIA
Mailing Address - State:AL
Mailing Address - Zip Code:35243-5711
Mailing Address - Country:US
Mailing Address - Phone:205-271-2584
Mailing Address - Fax:120-525-9162
Practice Address - Street 1:4268 CAHABA HEIGHTS CT
Practice Address - Street 2:SUITE 190 C
Practice Address - City:VESTAVIA
Practice Address - State:AL
Practice Address - Zip Code:35243-5711
Practice Address - Country:US
Practice Address - Phone:205-271-2584
Practice Address - Fax:205-259-1626
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-04
Last Update Date:2015-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1661251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health