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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DR. DEIRDRE RENEE' JACKSON, PHD LCMHCS LPC NCC

Active Sole Proprietor

DR. DEIRDRE RENEE' JACKSON, PHD LCMHCS LPC NCC is a Professional Counselor healthcare provider located in CLARKSVILLE, Tennessee. NPI 1215343009 is currently active in the NPPES registry. Verify at CMS.

Professional Counselor · CLARKSVILLE, TN

Registration Details

NPI Number
1215343009
Provider Type
Individual
Gender
Female
NPI Issued
Jul 1, 2014 (12.102869321926 yrs)
Last Updated
Jul 20, 2022
Licenses
S12958 (NC)
1744 (TN)
77544 (TX)
5911 (LA)
Sole Proprietor
Yes

Practice Information

Address
1059 SPICER DR
CLARKSVILLE, TN, 370422120
Browse TN providers · Browse ZIP 37042
Phone
6154735152
Primary Specialty
Professional Counselor
101YP2500X
Additional Specialty
Professional Counselor
Additional Specialty
Professional Counselor
Additional Specialty
Professional Counselor

Other Professional Counselor Providers in CLARKSVILLE, TN

Name Credential NPI
MR. JUSTIN M. MICKLES MS 1649266388
MISS MICHELLE C DEMARSILIS LCSW 1598784852
KAREN E. FREEMAN LPC-MHSP 1235242108
MRS. ANITA RANDOLPH LPS/MHSP 1306974357
BEGUM YASMIN SARWAR 1033247739
MRS. STACEY COULTER LPE 1336277003
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.