Jackson, Nyles Antony

Jackson, Nyles Antony is an individual health care provider with primary practice located at 4109 67Th St , Kenosha WI 53142-3836. 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 / Social Worker. Behavioral Health & Social Service Providers / Social Worker is his primary health care specialty. Jackson, Nyles Antony can be contacted via phone (262) 652-9830.

Contact Information

Primary practice address
4109 67Th St Kenosha WI 53142-3836
Phone: (262) 652-9830
Fax: (262) 652-2931
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 15877-130 Wisconsin
Behavioral Health & Social Service Providers / Social Worker 104100000X 128033-121 Wisconsin

Profile Details

NPI number 1053637629
LBN Legal business name Jackson, Nyles Antony
Credentials MSW, APSW, SAC-IT
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 7th, 2010
Last updated Apr 7th, 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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