Jackson, Shannon

Jackson, Shannon is an sole proprietor health care provider with primary practice located at 150 North Main St Echn Health Services, Manchester CT 06040-4188. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Jackson, Shannon can be contacted via phone (860) 647-6832.

Contact Information

Primary practice address
150 North Main St Echn Health Services Manchester CT 06040-4188
Fax: (860) 647-6831
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 00297 Connecticut

Profile Details

NPI number 1417281064
LBN Legal business name Jackson, Shannon
Credentials PSY.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 30th, 2009
Last updated Sep 30th, 2009 - about 16 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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