| Jackson Counseling Services | |
|
130 W Water St. Unit 1287 Toms River NJ 08753-0875 | |
| (732) 431-0646 | |
| Not Available |
| Full Name | Jackson Counseling Services |
|---|---|
| Speciality | Counselor |
| Location | 130 W Water St., Toms River, New Jersey |
| Authorized Official Name and Position | Jennell Ann Jackson (PROVIDER) |
| Authorized Official Contact | 7327848309 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jackson Counseling Services Po Box 1287 Toms River NJ 08754-1287 Ph: (732) 431-0646 | Jackson Counseling Services 130 W Water St. Unit 1287 Toms River NJ 08753-0875 Ph: (732) 431-0646 |
| NPI Number | 1740640184 |
|---|---|
| Provider Enumeration Date | 02/27/2016 |
| Last Update Date | 12/20/2022 |
| Certification Date | 12/19/2022 |
| Medicare PECOS PAC ID | 9133485824 |
|---|---|
| Medicare Enrollment ID | O20171114000031 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740640184 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Jennell Ann Jackson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841452356 PECOS PAC ID: 8628212941 Enrollment ID: I20130926000118 |
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