Jackson, Marguerite

Jackson, Marguerite is an sole proprietor health care provider with primary practice located at 7556 Woodcrest Ave , Philadelphia PA 19151-2704. She recently has 5 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 / Professional, Behavioral Health & Social Service Providers / Psychologist, Behavioral Health & Social Service Providers / Health Service. Behavioral Health & Social Service Providers / Mental Health is her primary health care specialty. Jackson, Marguerite can be contacted via phone (215) 400-1551.

Contact Information

Primary practice address
7556 Woodcrest Ave Philadelphia PA 19151-2704
Phone: (215) 400-1551
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X
Behavioral Health & Social Service Providers / Mental Health 101YM0800X
Behavioral Health & Social Service Providers / Professional 101YP2500X
Behavioral Health & Social Service Providers / Psychologist 103T00000X
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 103TA0400X
Behavioral Health & Social Service Providers / Health Service 103TH0100X

Profile Details

NPI number 1053733782
LBN Legal business name Jackson, Marguerite
Credentials M.ED, BCPC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 15th, 2014
Last updated Mar 22nd, 2017 - about 7 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 1053733782 NPPES
Pennsylvania MEDICAID 29692MD048189L
Pennsylvania Other 30053142

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