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:
Health care specialties
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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1053733782 | NPPES |
| Pennsylvania | MEDICAID | 29692MD048189L | |
| Pennsylvania | Other | 30053142 |
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