IndividualActive
Charles Jackson, PH.D.
NPI 1851315766 · Counseling Psychologist · Conway, SC
Provider details
- NPI number
- 1851315766
- Entity type
- Individual
- Primary specialty
- Counseling PsychologistBehavioral Health & Social Service Providers
- Credential
- PH.D.
- Sex
- Male
- Sole proprietor
- Yes
- License
- 182 (SC)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Practice location
210 University Plaza Dr
Conway, SC 29526-8978
Phone: (843) 347-2550
Approximate (ZIP-level) locationGet directions
Mailing address
5315 N Kings Hwy
Myrtle Beach, SC 29577-2534
Registry dates
- Enumerated
- 2006-07-26
- Last updated
- 2007-07-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.