Jackson, Crystal
Jackson, Crystal is an individual health care provider with primary practice located at 1035 Cheraw St. , Bennettsville SC 29512. She recently has only one registered license in Behavioral Health & Social Service Providers / Counselor, which is considered as her primary health care specialty. Jackson, Crystal can be contacted via phone (843) 454-0442.Contact Information
Primary practice address
1035 Cheraw St.
Bennettsville SC 29512
Phone: (843) 454-0442
Fax: (843) 454-0212
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Counselor | 101Y00000X |
Profile Details
| NPI number | 1972837110 |
|---|---|
| LBN Legal business name | Jackson, Crystal |
| Credentials | Master of Arts (MA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 21st, 2009 |
| Last updated | Sep 22nd, 2009 - about 17 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 | 1972837110 | NPPES |
| South Carolina | MEDICAID | 405127 |
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