| Dorye Jackson Llc | |
|
50 Washington St Norwalk CT 06854-2710 | |
| (203) 977-3503 | |
| Not Available |
| Full Name | Dorye Jackson Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 50 Washington St, Norwalk, Connecticut |
| Authorized Official Name and Position | Dorye Emory Jackson (LCSW) |
| Authorized Official Contact | 2039793503 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dorye Jackson Llc 458 Wire Mill Rd Stamford CT 06903-4711 Ph: (203) 979-3503 | Dorye Jackson Llc 50 Washington St Norwalk CT 06854-2710 Ph: (203) 977-3503 |
| NPI Number | 1205313947 |
|---|---|
| Provider Enumeration Date | 07/25/2018 |
| Last Update Date | 07/25/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205313947 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 008194 (Connecticut) | Primary |
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