MS. GRETCHEN D JACKSON LCPC
NPI 1780822734
Counselor - Professional in East Alton, IL
Active since January 29, 2009
2 TERMINAL DR, SUITE 8, EAST ALTON, IL 62024(618) 258-0485(618) 258-4815 Get Directions Write a Review
About Ms. Gretchen D Jackson Lcpc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MS. GRETCHEN D JACKSON LCPC (NPI 1780822734) is an individual professional provider in East Alton, Illinois, licensed in Illinois (018-006325) and active in the NPI registry since January 2009.
NPPES Registry Identity
NPI1780822734
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameMS. GRETCHEN D JACKSONCredential: LCPC
Location Address2 TERMINAL DR, SUITE 8East Alton, IL 62024-2201
Mailing Address2 Terminal Dr, Suite 8East Alton, IL 62024-2201 · (618) 258-0485 · Fax (618) 258-4815
Phone(618) 258-0485
Fax(618) 258-4815
Sole ProprietorNo
Enumeration DateJanuary 29, 2009
✔ NPI 1780822734 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in IL · 018-006325
2 TERMINAL DR, East Alton, IL 62024
Other Providers at the Same Location NPPES 15
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Clinic/Center (Federally Qualified Health Center (FQHC))
2 TERMINAL DR, SUITE 8
EAST ALTON, IL 62024
EAST ALTON, IL 62024
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1780822734, enumerated as an "individual" on January 29, 2009.
The provider is located at 2 TERMINAL DR SUITE 8 EAST ALTON, IL 62024 and the phone number is (618) 258-0485.
Counselor with taxonomy code 101YP2500X and a focus in Professional.
