IndividualActive
Shantell M Jackson
NPI 1386598597 · Pastoral Counselor · Detroit, MI
Provider details
- NPI number
- 1386598597
- Entity type
- Individual
- Primary specialty
- Pastoral CounselorBehavioral Health & Social Service Providers
- Sex
- Female
- Sole proprietor
- Yes
- License
- J250765585757 (MI)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Practice location
18256 Ashton Ave
Detroit, MI 48219-2957
Phone: (313) 475-6685
Approximate (ZIP-level) locationGet directions
Mailing address
18256 Ashton Ave
Detroit, MI 48219-2957
Registry dates
- Enumerated
- 2026-02-24
- Last updated
- 2026-02-24
- Certified
- 2026-02-24
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.