IndividualActive
Audrey Jackson, PCNHT
NPI 1366209264 · Mental Health Counselor · Laurel, MS
Provider details
- NPI number
- 1366209264
- Entity type
- Individual
- Primary specialty
- Mental Health CounselorBehavioral Health & Social Service Providers
- Credential
- PCNHT
- Sex
- Female
- Sole proprietor
- No
- License
- 5805 (MS)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Practice location
1721 W 10th St
Laurel, MS 39440-2540
Phone: (601) 425-9322
Fax: (601) 425-3231
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 18679
Hattiesburg, MS 39404-8679
Registry dates
- Enumerated
- 2024-03-06
- Last updated
- 2024-03-06
- Certified
- 2024-03-06
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.