Jackson, Ursula Ann
Jackson, Ursula Ann is an individual health care provider with primary practice located at 450 Forbes St , East Hartford CT 06118-1716. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Jackson, Ursula Ann can be contacted via phone (860) 622-5340.Contact Information
Primary practice address
450 Forbes St
East Hartford CT 06118-1716
Phone: (860) 622-5340
Fax: (860) 622-5342
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 006586 | Connecticut |
Profile Details
| NPI number | 1184952459 |
|---|---|
| LBN Legal business name | Jackson, Ursula Ann |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 25th, 2009 |
| Last updated | Dec 2nd, 2009 - about 15 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 | 1184952459 | NPPES |
| Connecticut | Other | 006586 | LICENSE |
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