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MS. SANDRA J JACKSON LCAC CADAC IV NADAC
NPI 1124449053
Counselor - Addiction (Substance Use Disorder) in South Bend, IN

Active since December 19, 2013
4218 WESTERN AVE., SOUTH BEND, IN 46619(574) 233-1524 Get Directions Write a Review

NPPES record last updated: December 19, 2013. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Ms. Sandra J Jackson Lcac Cadac Iv Nadac NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MS. SANDRA J JACKSON LCAC CADAC IV NADAC (NPI 1124449053) is an individual addiction (substance use disorder) provider in South Bend, Indiana, licensed in Indiana (88000353A) and active in the NPI registry since December 2013.Information from the official NPPES registry record, last updated December 19, 2013.

NPPES Registry Identity

NPI1124449053
Entity TypeIndividualFemale
Provider Legal NameMS. SANDRA J JACKSONCredential: LCAC CADAC IV NADAC
Location Address4218 WESTERN AVE.South Bend, IN 46619
Mailing Address4218 Western Ave.South Bend, IN 46619 · (574) 274-1524 · Fax (574) 274-1612
Phone(574) 233-1524
Sole ProprietorNo
Enumeration DateDecember 19, 2013
✔ NPI 1124449053 is a valid, active identifier and passes the ISO check-digit test. How NPI validation works

★ Primary Specialty

Counselor · Addiction (Substance Use Disorder)

Taxonomy 101YA0400X · Behavioral Health & Social Service Providers

✔ Licensed in IN · 88000353A
4218 WESTERN AVE., South Bend, IN 46619
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Reviews for MS. SANDRA J JACKSON LCAC CADAC IV NADAC

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Frequently Asked Questions

What is Sandra Jackson's NPI number?

The NPI number assigned to this healthcare provider is 1124449053, enumerated as an "individual" on December 19, 2013.

Where is the provider located?

The provider is located at 4218 WESTERN AVE. SOUTH BEND, IN 46619 and the phone number is (574) 233-1524.

What is the provider's specialty?

Counselor with taxonomy code 101YA0400X and a focus in Addiction (Substance Use Disorder).