IndividualActive
Fredericka Jackson, PH.D. CAC II
NPI 1922089531 · Addiction (Substance Use Disorder) Psychologist · Troy, MI
Provider details
- NPI number
- 1922089531
- Entity type
- Individual
- Primary specialty
- Addiction (Substance Use Disorder) PsychologistBehavioral Health & Social Service Providers
- Credential
- PH.D. CAC II
- Sex
- Female
- Sole proprietor
- Yes
- License
- 6301008884 (MI)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Behavioral Health & Social Service Providers
Practice location
38815 Dequindre Rd
Troy, MI 48083-5769
Phone: (248) 250-7323
Approximate (ZIP-level) locationGet directions
Mailing address
43220 Fountain Dr
Sterling Heights, MI 48313-2394
Registry dates
- Enumerated
- 2005-11-10
- Last updated
- 2025-09-11
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.