Jackson, Dawn A

Jackson, Dawn A is an individual health care provider with primary practice located at 3737 Lander Rd , Pepper Pike OH 44124-5712. She recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as her primary health care specialty. Jackson, Dawn A can be contacted via phone (216) 831-2255.

Contact Information

Primary practice address
3737 Lander Rd Pepper Pike OH 44124-5712
Fax: (216) 378-3906
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X C.0800348 Ohio
Behavioral Health & Social Service Providers / Professional 101YP2500X C.0800348-CR Ohio

Profile Details

NPI number 1043517121
LBN Legal business name Jackson, Dawn A
Credentials Licensed Professional Counselor (LPC)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 25th, 2011
Last updated Feb 25th, 2011 - about 13 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 1043517121 NPPES
Ohio MEDICAID 0268768

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