Jackson, Charles W

Jackson, Charles W is an sole proprietor health care provider with primary practice located at 210 University Plaza Dr , Conway SC 29526-8978. He recently has only one registered license in Behavioral Health & Social Service Providers / Counseling, which is considered as his primary health care specialty. Jackson, Charles W can be contacted via phone (843) 347-2550.

Contact Information

Primary practice address
210 University Plaza Dr Conway SC 29526-8978
Phone: (843) 347-2550
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counseling 103TC1900X 182 South Carolina

Profile Details

NPI number 1851315766
LBN Legal business name Jackson, Charles W
Credentials PH.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 26th, 2006
Last updated Jul 8th, 2007 - about 18 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1851315766 NPPES
South Carolina Other 182 COUNSELING PSYCHOLOGIST

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