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Contact Information

COURTNEY JACKSON
250 GEORGIA AVE SE
SUITE 206
ATLANTA, GA30312
 Phone: 202-441-3364
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Other Service Providers

175T00000X
 

Clinical

1041C0700X 80 Licensed Clinical Social Worker
Indicates primary specialty

NPI Profile & details for COURTNEY JACKSON · (Male)

NPI # 1992352421
Status Active
Credentials
Entity Individual
Enumeration date 08/20/2019
Last updated 10/20/2025 - About 8 months ago
Sole proprietor 1 Yes
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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