Jackson, James Edward

Jackson, James Edward is an sole proprietor health care provider with primary practice located at 736 Se 18Th Ave , Ocala FL 34471-4114. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Mental Health is his primary health care specialty. Jackson, James Edward can be contacted via phone (352) 572-0138.

Contact Information

Primary practice address
736 Se 18Th Ave Ocala FL 34471-4114
Phone: (352) 572-0138
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X ISW2250 Florida
Behavioral Health & Social Service Providers / Mental Health 101YM0800X ISW2250 Florida

Profile Details

NPI number 1518003078
LBN Legal business name Jackson, James Edward
Credentials M.S.W.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 30th, 2007
Last updated Feb 22nd, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1518003078 NPPES
Florida MEDICAID 101875000

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