Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
SHANE MICHELL JACKSON, LPC
Active Sole ProprietorSHANE MICHELL JACKSON, LPC is a Addiction (Substance Use Disorder) Counselor healthcare provider located in GILMER, Texas. NPI 1922173897 is currently active in the NPPES registry. Verify at CMS.
Addiction (Substance Use Disorder) Counselor · GILMER, TX
Registration Details
- NPI Number
- 1922173897
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Nov 22, 2006 (19.707926655193 yrs)
- Last Updated
- Sep 11, 2025
- Licenses
-
4128 (TX)16480 (TX)
- Sole Proprietor
- Yes
Practice Information
- Address
-
115 W TYLER STGILMER, TX, 756442239Browse TX providers · Browse ZIP 75644
- Phone
- 9037467643
- Fax
- 9038434336
- Primary Specialty
-
Addiction (Substance Use Disorder) Counselor
101YA0400X
- Additional Specialty
- Mental Health Counselor
Other Addiction (Substance Use Disorder) Counselor Providers in GILMER, TX
| Name | Credential | NPI |
|---|---|---|
| WANDA MARIE KENNEL | LCDC, LSBW | 1144278714 |
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.