JORDYNE JACKSON
NPI 1780414516
Counselor - Professional in Matteson, IL
Active since August 06, 2024
About Jordyne Jackson NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JORDYNE JACKSON (NPI 1780414516) is an individual professional provider in Matteson, Illinois, licensed in Illinois (180.016273) and active in the NPI registry since August 2024.
NPPES Registry Identity
NPI1780414516
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameJORDYNE JACKSON
Location Address8215 W LINCOLN HWYMatteson, IL 60443
Mailing Address8544 S Sangamon St Apt 2Chicago, IL 60620-3214 · (773) 322-5577
Phone(877) 929-6283
Sole ProprietorNo
Enumeration DateAugust 6, 2024
NPPES CertifiedJuly 30, 2024
✔ NPI 1780414516 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
Licenses✔ Licensed in IL · 180.016273✔ Licensed in IL · 180016273
8215 W LINCOLN HWY, Matteson, IL 60443
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1780414516, enumerated as an "individual" on August 06, 2024.
The provider is located at 8215 W LINCOLN HWY MATTESON, IL 60443 and the phone number is (877) 929-6283.
Counselor with taxonomy code 101YP2500X and a focus in Professional.
