Mr Jerry Camal Jackson, BA is a
Social Worker - Clinical based in Detroit, Michigan. Mr Jerry Camal Jackson is licensed to practice in * (Not Available) (license number ) and his current practice location is
2925 Russell St, Detroit, Michigan. He can be reached at his office (for appointments etc.) via phone at
(313) 603-0603.
NPI number for Mr Jerry Camal Jackson is 1528182102 and his current mailing address is 4710 W Saginaw Hwy Ste 1, Lansing, Michigan. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1528182102.
Healthcare Provider's Profile
| Full Name | Mr Jerry Camal Jackson |
|---|
| Gender | Male |
|---|
| Speciality | Social Worker - Clinical |
|---|
| Location | 2925 Russell St, Detroit, Michigan |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1528182102
- Provider Enumeration Date: 03/19/2007
- Last Update Date: 10/10/2024
Medical Identifiers
Medical identifiers for Mr Jerry Camal Jackson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1528182102 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Secondary |
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Jerry Camal Jackson is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Mr Jerry Camal Jackson, BA
4710 W Saginaw Hwy Ste 1,
Lansing, MI 48917-2654
Ph: (517) 914-2288 | Mr Jerry Camal Jackson, BA
2925 Russell St,
Detroit, MI 48207-4825
Ph: (313) 603-0603 |
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