Marcus Kirk Jackson in Bridgeport - Clinical
Marcus Kirk Jackson - NPI 1902964240
Marcus Kirk Jackson is a Clinical in Bridgeport, Connecticut. Marcus Kirk Jackson practices all healthcare services and medical treatments related to Clinical. The NPI Number for Marcus Kirk Jackson is 1902964240. The last update date is 2007-07-08.
Marcus Kirk Jackson's current location address is 1635 Central Avenue, Bridgeport, Connecticut. You can contact this provider via phone number 2035517660 and fax number 2035517481. The mailing address for Marcus Kirk Jackson is 1635 Central Avenue, Bridgeport, Connecticut. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Marcus Kirk Jackson |
|---|---|
| Address | 1635 Central Avenue, Bridgeport, Connecticut |
| Phone Number | 2035517660 |
| Fax Number | 2035517481 |
| Sole Proprietor | N |
| Credentials | LCSW |
NPI Number Detail
| NPI Number | 1902964240 |
|---|---|
| Provider Enumeration Date | 2006-12-05 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 1635 Central Avenue |
|---|---|
| City | Bridgeport |
| State | Connecticut (CT) |
| Post Code | 6610 |
| Phone Number | 2035517660 |
| Fax Number | 2035517481 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 1041C0700X |
| Licence No | 5455 |
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Definition: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certif |
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What is the unique identifier code issued to Marcus Kirk Jackson by the Centers for Medicare & Medicaid Services (CMS)?
The Marcus Kirk Jackson has been assigned the NPI (National Provider Identifier) 1902964240. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Where is the Marcus Kirk Jackson located?
The Marcus Kirk Jackson is located at 1635 Central Avenue, Bridgeport, CT 6610.
What is Marcus Kirk Jackson's area of specialization, and what is the corresponding taxonomy classification code for this field of practice?
The specialized area of practice for Marcus Kirk Jackson is Clinical, and the taxonomy code that categorizes this field of expertise is 1041C0700X.
When did the Marcus Kirk Jackson receive its 1902964240?
The Marcus Kirk Jackson was issued its 1902964240 on 2006-12-05, which is the date when the organization was assigned this unique identifier.
As of what date were the details pertaining to Marcus Kirk Jackson last refreshed?
The information related to the Marcus Kirk Jackson, including its address, specialty, and other relevant details, was last updated on 2007-07-08.
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