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General NPI Number Information
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NPI Number | 1902388333
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Entity Type | Individual
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Provider Name | JUDY GAIL WHITE-JACKSON MA, LPC
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Gender | Female
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Dates
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Enumeration Date | 09/01/2018
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Last Update Date | 06/24/2025
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Provider Practice Location Address
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Address Line | 505 N SAM HOUSTON PKWY E STE 303
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City | HOUSTON
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State | TX
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Zip | 77060-4086
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Country | US
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Telephone | 281-687-7053
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Fax | 832-617-8347
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Provider Business Mailing Address
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Address Line | 505 N SAM HOUSTON PKWY E STE 303
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City | HOUSTON
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State | TX
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Zip | 77060-4086
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Country | US
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Telephone | 281-687-7053
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Fax | 832-617-8347
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 9899
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 76030
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License Number State | TX
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