Jackson, John Edward

Jackson, John Edward is an sole proprietor health care provider with primary practice located at 1851 Nw 123Rd Ave , Pembroke Pines FL 33026-3825. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) is his primary health care specialty. Jackson, John Edward can be contacted via phone (954) 432-2100.

Contact Information

Primary practice address
1851 Nw 123Rd Ave Pembroke Pines FL 33026-3825
Phone: (954) 432-2100
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 3282 Florida
Behavioral Health & Social Service Providers / Mental Health 101YM0800X MH8379 Florida

Profile Details

NPI number 1285853481
LBN Legal business name Jackson, John Edward
Credentials BS MS,LMHC,CAP
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 25th, 2007
Last updated Jul 8th, 2007 - about 17 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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