Jackson, Andrea Lane

Jackson, Andrea Lane is an sole proprietor health care provider with primary practice located at 138 W 27Th St Apt 2 , Bayonne NJ 07002-1712. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Social Worker, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Jackson, Andrea Lane can be contacted via phone (845) 220-6428.

Contact Information

Primary practice address
138 W 27Th St Apt 2 Bayonne NJ 07002-1712
Phone: (845) 220-6428
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Social Worker 104100000X 087822 New York
Behavioral Health & Social Service Providers / Clinical 1041C0700X 091378 New York

Profile Details

NPI number 1679003099
LBN Legal business name Jackson, Andrea Lane
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 18th, 2017
Last updated Jul 21st, 2022 - about 2 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.

Request for update

Popular Providers