Jackson, Tierra

Jackson, Tierra is an sole proprietor health care provider with primary practice located at 4680 Lipscomb St Ne Suite 10A, Palm Bay FL 32905-2984. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Marriage & Family Therapist, Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Marriage & Family Therapist is her primary health care specialty. Jackson, Tierra can be contacted via phone (321) 433-3570.

Contact Information

Primary practice address
4680 Lipscomb St Ne Suite 10A Palm Bay FL 32905-2984
Phone: (321) 433-3570
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X IMT2200 Florida
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X 9096A North Carolina
Behavioral Health & Social Service Providers / Professional 101YP2500X A10704 North Carolina

Profile Details

NPI number 1225440548
LBN Legal business name Jackson, Tierra
Credentials LPCA, LMFTA, RMFTI
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 21st, 2014
Last updated Dec 17th, 2014 - about 11 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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