Provider Demographics
NPI:1245065606
Name:JACKSON, BRITTANY KASSANDRA (MA PPS APCC LMHCA)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:KASSANDRA
Last Name:JACKSON
Suffix:
Gender:F
Credentials:MA PPS APCC LMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9208 NE HIGHWAY 99 # 107-45
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98665-8986
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9208 NE HIGHWAY 99 # 107-45
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98665-8986
Practice Address - Country:US
Practice Address - Phone:858-585-3057
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-05
Last Update Date:2025-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC61647117101YM0800X
CA17732101YM0800X
CA240164012101YS0200X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool