| Dr Ulysses Jackson Licensed Mental Health Counseling Pllc | |
|
89 Washington Ave Deer Park NY 11729-6917 | |
| (631) 767-9294 | |
| Not Available |
| Full Name | Dr Ulysses Jackson Licensed Mental Health Counseling Pllc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 89 Washington Ave, Deer Park, New York |
| Authorized Official Name and Position | Ulysses Jackson (OWNER) |
| Authorized Official Contact | 6317679294 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Ulysses Jackson Licensed Mental Health Counseling Pllc 89 Washington Ave Deer Park NY 11729-6917 Ph: (631) 767-9294 | Dr Ulysses Jackson Licensed Mental Health Counseling Pllc 89 Washington Ave Deer Park NY 11729-6917 Ph: (631) 767-9294 |
| NPI Number | 1861112336 |
|---|---|
| Provider Enumeration Date | 09/02/2022 |
| Last Update Date | 09/02/2022 |
| Certification Date | 09/02/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861112336 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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