Ellsworth Jackson in Madison Heights - Clinical
Ellsworth Jackson - NPI 1467660183
Ellsworth Jackson is a Clinical in Madison Heights, Michigan. Ellsworth Jackson practices all healthcare services and medical treatments related to Clinical. The NPI Number for Ellsworth Jackson is 1467660183. The last update date is 2007-07-08.
Ellsworth Jackson's current location address is 27351 Dequindre Rd, Madison Heights, Michigan. You can contact this provider via phone number 2489677320 and fax number 2489677369. The mailing address for Ellsworth Jackson is 27351 Dequindre Rd, Madison Heights, Michigan. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Ellsworth Jackson |
|---|---|
| Address | 27351 Dequindre Rd, Madison Heights, Michigan |
| Phone Number | 2489677320 |
| Fax Number | 2489677369 |
| Sole Proprietor | N |
| Credentials | MSW |
NPI Number Detail
| NPI Number | 1467660183 |
|---|---|
| Provider Enumeration Date | 2007-05-18 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 27351 Dequindre Rd |
|---|---|
| City | Madison Heights |
| State | Michigan (MI) |
| Post Code | 480713487 |
| Phone Number | 2489677320 |
| Fax Number | 2489677369 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 1041C0700X |
| Licence No | 6801035402 |
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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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Post Comment/ Review Below
What is the unique identifier code issued to Ellsworth Jackson by the Centers for Medicare & Medicaid Services (CMS)?
The Ellsworth Jackson has been assigned the NPI (National Provider Identifier) 1467660183. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Could you provide the complete physical address where Ellsworth Jackson is located?
The Ellsworth Jackson is situated at the following address: 27351 Dequindre Rd, Madison Heights, MI, 480713487.
What is Ellsworth Jackson's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Ellsworth Jackson's specialized field of practice is Clinical, and the corresponding taxonomy code that categorizes this area of specialization is 1041C0700X.
When did the Ellsworth Jackson receive its 1467660183?
The Ellsworth Jackson was issued its 1467660183 on 2007-05-18, which is the date when the organization was assigned this unique identifier.
When was the Ellsworth Jackson's information last updated?
The Ellsworth Jackson's information was last updated on 2007-07-08.