Jack, Derrick

Jack, Derrick is an individual health care provider with primary practice located at 2627 Charlestown Rd , New Albany IN 47150-2536. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Jack, Derrick can be contacted via phone (812) 944-1550.

Contact Information

Primary practice address
2627 Charlestown Rd New Albany IN 47150-2536
Phone: (812) 944-1550
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 34012719A Indiana

Profile Details

NPI number 1265096994
LBN Legal business name Jack, Derrick
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 29th, 2019
Last updated May 18th, 2026 - about 6 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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