Dorothy Jane Jackson in Cheshire - Clinical
Dorothy Jane Jackson - NPI 1104876374
Dorothy Jane Jackson is a Clinical in Cheshire, Connecticut. Dorothy Jane Jackson practices all healthcare services and medical treatments related to Clinical. The NPI Number for Dorothy Jane Jackson is 1104876374. The last update date is 2007-07-09.
Dorothy Jane Jackson's current location address is 350 S Main St, Cheshire, Connecticut. You can contact this provider via phone number 2032711234 and fax number 2032729094. The mailing address for Dorothy Jane Jackson is 350 S Main St, Cheshire, Connecticut. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Dorothy Jane Jackson |
|---|---|
| Address | 350 S Main St, Cheshire, Connecticut |
| Phone Number | 2032711234 |
| Fax Number | 2032729094 |
| Sole Proprietor | X |
| Credentials | LCSW |
NPI Number Detail
| NPI Number | 1104876374 |
|---|---|
| Provider Enumeration Date | 2006-05-11 |
| Last Updated Date | 2007-07-09 |
Provider Mailing Address Detail
| Address | 350 S Main St |
|---|---|
| City | Cheshire |
| State | Connecticut (CT) |
| Post Code | 64103160 |
| Phone Number | 2032711234 |
| Fax Number | 2032729094 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 1041C0700X |
| Licence No | 101 |
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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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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1288076 | CT | AETNA | |
| 1400000101CT02 | CT | BCBS |
Post Comment/ Review Below
What is the unique 10-digit identifier code assigned to Dorothy Jane Jackson by the Centers for Medicare & Medicaid Services?
The Dorothy Jane Jackson has been issued the NPI (National Provider Identifier) 1104876374 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Where is the Dorothy Jane Jackson located?
The Dorothy Jane Jackson is located at 350 S Main St, Cheshire, CT 64103160.
What is the Dorothy Jane Jackson's specialty and taxonomy code?
The Dorothy Jane Jackson's specialty is Clinical, and the corresponding taxonomy code is 1041C0700X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1104876374 to Dorothy Jane Jackson?
The Centers for Medicare & Medicaid Services originally issued the 1104876374 to Dorothy Jane Jackson on 2006-05-11.
When was the information pertaining to Dorothy Jane Jackson most recently updated or revised?
The details related to Dorothy Jane Jackson, including its address, specialty, and other relevant information, were last updated or revised on 2007-07-09.