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Angela Jackson, PH.D., LCPC, LMHC — NPI 1194267476, South Bend, IN | NPI Central

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NPI 1194267476

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Angela Jackson, PH.D., LCPC, LMHC

NPI 1194267476 · Professional Counselor · South Bend, IN

Provider details

NPI number: 1194267476
Entity type: Individual
Primary specialty: Professional CounselorBehavioral Health & Social Service Providers
Credential: PH.D., LCPC, LMHC
Sex: Female
Sole proprietor: No
License: 180.011258 (IL)

Specialties & taxonomies

Professional CounselorPrimary101YP2500XLicense 39004648A (IN)
Behavioral Health & Social Service Providers
Professional Counselor101YP2500XLicense 180.011258 (IL)
Behavioral Health & Social Service Providers

Practice location

1251 N Eddy St Ste 200

South Bend, IN 46617-1478

Phone: (312) 798-9755

Approximate (ZIP-level) locationGet directions

More IN providers

Mailing address

1251 N Eddy St Ste 200

South Bend, IN 46617-1478

Additional practice locations (1)

1251 N Eddy St Ste 200
South Bend, IN 46617-1478
Phone: (312) 798-9755

Registry dates

Enumerated: 2016-11-17
Last updated: 2025-06-25
Certified: 2025-06-25

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.