Jackson, Derrick Jerome
Jackson, Derrick Jerome is an individual health care provider with primary practice located at 114 Orchard Lake Rd , Pontiac MI 48341-2244. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Jackson, Derrick Jerome can be contacted via phone (248) 858-7766.Contact Information
Primary practice address
114 Orchard Lake Rd
Pontiac MI 48341-2244
Phone: (248) 858-7766
Fax: (248) 858-7112
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 6801094410 | Michigan |
Profile Details
| NPI number | 1588928626 |
|---|---|
| LBN Legal business name | Jackson, Derrick Jerome |
| Credentials | LLMSW |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 3rd, 2012 |
| Last updated | Jul 3rd, 2012 - about 14 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.
Popular Providers
-
Quinn, Chelsea
114 Orchard Lake Rd , Pontiac MI 48341-2244 -
Jeffery, Karen Marie
691 Orchard Lake Rd , Pontiac MI 48341-2039 -
Laus, Patrick
35 S Johnson St Ste 3C , Pontiac MI 48341-1662 -
James, Antonett Clarese
1685 Baldwin Ave Ste A, Pontiac MI 48340-1115 -
Maxwell, Renee
46 N Saginaw St , Pontiac MI 48342-2155 -
Kossman, Sharon Michelle
114 Orchard Lake Rd , Pontiac MI 48341-2244 -
Warner, Chelsea
1685 Baldwin Ave Suite A, Pontiac MI 48340-1115 -
Kaatz, Pamela Ann
1685 Baldwin Ave Ste 100 , Pontiac MI 48340-1242