Jackson, Amber Adney
Jackson, Amber Adney is an sole proprietor health care provider with primary practice located at 528 N College Ave Ste 2 , Fayetteville AR 72701-3401. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Jackson, Amber Adney can be contacted via phone (479) 856-9956.Contact Information
Primary practice address
528 N College Ave Ste 2
Fayetteville AR 72701-3401
Phone: (479) 856-9956
Fax: (888) 455-6401
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 1934-C | Arkansas |
Profile Details
| NPI number | 1912944158 |
|---|---|
| LBN Legal business name | Jackson, Amber Adney |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 31st, 2006 |
| Last updated | Dec 15th, 2021 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1912944158 | NPPES |
| Arkansas | Other | 5Y354 | BLUE SHIELD PROVIDER # |
| Arkansas | Other | 747768 | BLUE SHIELD PROVIDER # |
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