Jackson, Carl Edward

Jackson, Carl Edward is an sole proprietor health care provider with primary practice located at 120 W Broadway St , Altus OK 73521-3802. He recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as his primary health care specialty. Jackson, Carl Edward can be contacted via phone (580) 954-5966.

Contact Information

Primary practice address
120 W Broadway St Altus OK 73521-3802
Phone: (580) 954-5966
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X 6694 Oklahoma

Profile Details

NPI number 1891078671
LBN Legal business name Jackson, Carl Edward
Credentials M.S. LPC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 28th, 2011
Last updated Oct 8th, 2020 - about 6 years 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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