Healthcare Provider Details

I. General information

NPI: 1326531294
Provider Name (Legal Business Name): APRIL A JACKSON LLPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/14/2018
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24100 SOUTHFIELD RD STE 202
SOUTHFIELD MI
48075-2851
US

IV. Provider business mailing address

24100 SOUTHFIELD RD
SOUTHFIELD MI
48075-2819
US

V. Phone/Fax

Practice location:
  • Phone: 734-635-3544
  • Fax:
Mailing address:
  • Phone: 734-635-3544
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number6451024739
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: