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CHARLES JACKSON
NPI 1457896839
Counselor - Mental Health in Shreveport, LA

Active since December 21, 2016
2911 PENICK ST, SHREVEPORT, LA 71109(318) 393-8396 Get Directions Write a Review

NPPES record last updated: December 21, 2016. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Charles Jackson NPPES

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

CHARLES JACKSON (NPI 1457896839) is an individual mental health provider in Shreveport, Louisiana and active in the NPI registry since December 2016.

NPPES Registry Identity

NPI1457896839
Entity TypeIndividualMale
Primary Taxonomy101YM0800X
Provider Legal NameCHARLES JACKSON
Location Address2911 PENICK STShreveport, LA 71109-4337
Mailing Address2911 Penick StShreveport, LA 71109-4337 · (318) 393-8396
Phone(318) 393-8396
Sole ProprietorNo
Enumeration DateDecember 21, 2016
✔ NPI 1457896839 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
2911 PENICK ST, Shreveport, LA 71109
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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 Charles Jackson's NPI number?

The NPI number for Charles Jackson is 1457896839. It was assigned to this individual provider in the NPPES registry on December 21, 2016.

Where is Charles Jackson located?

Charles Jackson practices at 2911 Penick St, Shreveport, LA 71109. The listed phone number is (318) 393-8396.

What is Charles Jackson's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

When was this NPI record last updated?

The NPPES record for Charles Jackson was last updated on December 21, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.