Diane Cathleen Jackson in Fayetteville - Clinical
Diane Cathleen Jackson - NPI 1194765289
Diane Cathleen Jackson is a Clinical in Fayetteville, North Carolina. Diane Cathleen Jackson practices all healthcare services and medical treatments related to Clinical. The NPI Number for Diane Cathleen Jackson is 1194765289. The last update date is 2011-09-26.
Diane Cathleen Jackson's current location address is 806 Hay St, Fayetteville, North Carolina. You can contact this provider via phone number 9108223333 and fax number 9108223336. The mailing address for Diane Cathleen Jackson is 806 Hay St, Fayetteville, North Carolina. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Diane Cathleen Jackson |
|---|---|
| Address | 806 Hay St, Fayetteville, North Carolina |
| Phone Number | 9108223333 |
| Fax Number | 9108223336 |
| Sole Proprietor | Y |
| Credentials | LCSW |
NPI Number Detail
| NPI Number | 1194765289 |
|---|---|
| Provider Enumeration Date | 2006-06-07 |
| Last Updated Date | 2011-09-26 |
Provider Mailing Address Detail
| Address | 806 Hay St |
|---|---|
| City | Fayetteville |
| State | North Carolina (NC) |
| Post Code | 283055312 |
| Phone Number | 9108223333 |
| Fax Number | 9108223336 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 1041C0700X |
| Licence No | C004576 |
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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 |
|---|---|---|---|
| 136K7 | NC | BCBS OF NC | |
| 6003734 | NC | -- |
Post Comment/ Review Below
What is the Diane Cathleen Jackson's unique identification number?
The Diane Cathleen Jackson has been assigned the NPI (National Provider Identifier) Number 1194765289 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.
Could you please share the complete physical location address where Diane Cathleen Jackson's facilities are situated?
The facilities of Diane Cathleen Jackson are physically located at the following address: 806 Hay St, Fayetteville, NC, 283055312.
What is Diane Cathleen Jackson's specialized field of practice, and what is the corresponding taxonomy code that categorizes this area of expertise?
The area of specialization for Diane Cathleen Jackson is Clinical, and the taxonomy code that classifies this field of practice is 1041C0700X.
On what date was the 1194765289 assigned to Diane Cathleen Jackson?
The Diane Cathleen Jackson was issued its 1194765289 on 2006-06-07, which is the date when this unique identifier was assigned to the organization by the Centers for Medicare & Medicaid Services.
As of what date was the information regarding Diane Cathleen Jackson, such as address, specialty, and other details, last verified and confirmed to be up-to-date?
The information related to Diane Cathleen Jackson, including its address, specialty, and other relevant details, was last verified and confirmed to be up-to-date on 2011-09-26.