Provider Demographics
NPI:1861690190
Name:JACKSON, MARSHA (LMFT)
Entity type:Individual
Prefix:
First Name:MARSHA
Middle Name:
Last Name:JACKSON
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:MARSHA
Other - Middle Name:
Other - Last Name:REED
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMFT
Mailing Address - Street 1:107 COMMUNITY BLVD STE 2
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75605-6186
Mailing Address - Country:US
Mailing Address - Phone:903-650-9848
Mailing Address - Fax:
Practice Address - Street 1:107 COMMUNITY BLVD STE 2
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75605-6186
Practice Address - Country:US
Practice Address - Phone:903-650-9848
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-09
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health