Jackson, James C

Jackson, James C is an individual health care provider with primary practice located at 800 Preston Ave , Charlottesville VA 22903-4420. He recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as his primary health care specialty. Jackson, James C can be contacted via phone (434) 792-1800.

Contact Information

Primary practice address
800 Preston Ave Charlottesville VA 22903-4420
Phone: (434) 792-1800
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X 0701001993 Virginia

Profile Details

NPI number 1720121965
LBN Legal business name Jackson, James C
Credentials Licensed Professional Counselor (LPC)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 15th, 2007
Last updated Dec 10th, 2010 - about 14 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 1720121965 NPPES
Virginia MEDICAID 004945018

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