DEVONTE JACKSON - NPI 1417461120 - Counselor in Lake Village, AR

Q: What is Devonte Jackson's NPI number?

The NPI number for Devonte Jackson is 1417461120. It was assigned to this individual provider in the NPPES registry on November 17, 2017.

Q: What is Devonte Jackson's specialty?

The primary specialty registered for this NPI is Counselor with taxonomy code 101Y00000X.

Q: When was this NPI record last updated?

The NPPES record for Devonte Jackson was last updated on November 17, 2017. NPI Profile syncs with the weekly NPPES data releases published by CMS.

On this page

About Devonte Jackson NPPES

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

DEVONTE JACKSON (NPI 1417461120) is an individual counselor in Lake Village, Arkansas and active in the NPI registry since November 2017.

NPPES Registry Identity

NPI1417461120

Entity TypeIndividualMale

Primary Taxonomy101Y00000X

Provider Legal NameDEVONTE JACKSON

Location Address1652 S HIGHWAY 65 82Lake Village, AR 71653-1662

Mailing Address602 N Walton BlvdBentonville, AR 72712-4576 · (479) 464-1060 · Fax (479) 271-6307

Phone(870) 265-3711

Sole ProprietorNo

Enumeration DateNovember 17, 2017

✔ NPI 1417461120 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.

1652 S HIGHWAY 65 82, Lake Village, AR 71653

Open in Google Maps ↗

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KRISTINA MCINTYRE

Counselor