NPI 1033865639

Nicole Jackson, LGPC

Practitioner Mental Health Counselor Ellicott City, MD

Practice location

Address: 787 Oella Ave, Ellicott City, MD 21043-4727
Phone: (443) 720-0090
Mailing address: 2213 Rogene Dr APT 101, Baltimore, MD 21209-5730

Registered specialties

Mental Health Counselor Primary

Behavioral Health & Social Service Providers Taxonomy 101YM0800X Licence LGP12368 (MD)

Other Counselor providers in Maryland →

Registry record

NPI: 1033865639
Entity type: Individual
Sex (as registered): Female
NPI issued: 23 Feb 2022
Record last updated: 23 Feb 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.