Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
LAVILA D JACKSON
Active Sole ProprietorLAVILA D JACKSON is a Community/Behavioral Health healthcare provider located in COLUMBIA, Maryland. NPI 1639855836 is currently active in the NPPES registry. Verify at CMS.
Community/Behavioral Health · COLUMBIA, MD
Registration Details
- NPI Number
- 1639855836
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Jun 23, 2023 (3.1811922286263 yrs)
- Last Updated
- Oct 15, 2024
- Sole Proprietor
- Yes
Practice Information
- Address
-
7090 SAMUEL MORSE DR STE 100COLUMBIA, MD, 210463444Browse MD providers · Browse ZIP 21046
- Phone
- 4438527036
- Primary Specialty
-
Community/Behavioral Health
251S00000X
- Additional Specialty
- Counselor
- Additional Specialty
- Case Manager
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.