Provider Demographics
NPI:1508075359
Name:JACKSON, ALANA (MS, LCADL, CPC)
Entity Type:Individual
Prefix:
First Name:ALANA
Middle Name:
Last Name:JACKSON
Suffix:
Gender:F
Credentials:MS, LCADL, CPC
Other - Prefix:
Other - First Name:ALANA
Other - Middle Name:
Other - Last Name:MARKUSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2510 E SUNSET 5-74
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89120
Mailing Address - Country:US
Mailing Address - Phone:702-738-3395
Mailing Address - Fax:
Practice Address - Street 1:2904 W HORIZON RIDGE
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052
Practice Address - Country:US
Practice Address - Phone:702-738-3395
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2014-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor