Jackson, Carolyn
Jackson, Carolyn is an sole proprietor health care provider with primary practice located at 11616 Southfork Ave , Baton Rouge LA 70816-5241. She recently has only one registered license in Behavioral Health & Social Service Providers / Social Worker, which is considered as her primary health care specialty. Jackson, Carolyn can be contacted via phone (225) 291-9646.Contact Information
Primary practice address
11616 Southfork Ave
Baton Rouge LA 70816-5241
Phone: (225) 291-9646
Fax: (225) 291-9692
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Social Worker | 104100000X | Louisiana |
Profile Details
| NPI number | 1821460742 |
|---|---|
| LBN Legal business name | Jackson, Carolyn |
| Credentials | Bachelor of Social Work (BSW) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 30th, 2015 |
| Last updated | Oct 30th, 2015 - about 11 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1821460742 | NPPES |
| Louisiana | MEDICAID | 600751961 |
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