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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: August 23, 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.

NPPES Registry Identity

NPI1124449053
Entity TypeIndividualFemale
Primary Taxonomy101YA0400X
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.

Specialties & Licenses

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
License✔ Licensed in IN · 88000353A
4218 WESTERN AVE., South Bend, IN 46619
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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Sandra Jackson's NPI number?

The NPI number for Sandra Jackson is 1124449053. It was assigned to this individual provider in the NPPES registry on December 19, 2013.

Where is Sandra Jackson located?

Sandra Jackson practices at 4218 Western Ave., South Bend, IN 46619. The listed phone number is (574) 233-1524.

What is Sandra Jackson's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

When was this NPI record last updated?

The NPPES record for Sandra Jackson was last updated on December 19, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.