MR. COURTNEY LARESIC JACKSON
NPI 1417076241
Counselor in Sacramento, CA

Q: What is the provider's specialty?

The provider's specialty is Counselor with taxonomy code 101Y00000X.

Active since March 29, 2007

608 10TH ST, SACRAMENTO, CA 95814(916) 441-2933 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Mr. Courtney Laresic Jackson NPPES

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

MR. COURTNEY LARESIC JACKSON (NPI 1417076241) is an individual counselor in Sacramento, California and active in the NPI registry since March 2007.

NPPES Registry Identity

NPI1417076241

Entity TypeIndividualMale

Primary Taxonomy101Y00000X

Provider Legal NameMR. COURTNEY LARESIC JACKSON

Location Address608 10TH STSacramento, CA 95814-0712

Mailing Address3372 Rivermont StWest Sacramento, CA 95691-5443 · (916) 371-9338

Phone(916) 441-2933

Sole ProprietorNo

Enumeration DateMarch 29, 2007

Last NPPES UpdateJuly 8, 2007

✔ NPI 1417076241 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselorBehavioral Health & Social Service Providers

Taxonomy Code101Y00000X

Definition

A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.

608 10TH ST, Sacramento, CA 95814

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