Jackson, Diana Sue

Jackson, Diana Sue is an sole proprietor health care provider with primary practice located at 1744 2Nd Ave Se , Cedar Rapids IA 52403-2306. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Mental Health is her primary health care specialty. Jackson, Diana Sue can be contacted via phone (319) 366-4673.

Contact Information

Primary practice address
1744 2Nd Ave Se Cedar Rapids IA 52403-2306
Phone: (319) 366-4673
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 14116 Iowa
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 079713 Iowa

Profile Details

NPI number 1902352412
LBN Legal business name Jackson, Diana Sue
Credentials LMHC, CADC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 25th, 2016
Last updated May 1st, 2019 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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