Jackson, Jylian Ann

Jackson, Jylian Ann is an sole proprietor health care provider with primary practice located at 146 Pike Street Outpatient Clinic , Port Jervis NY 12771. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Social Worker, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Social Worker is her primary health care specialty. Jackson, Jylian Ann can be contacted via phone (845) 858-1456.

Contact Information

Primary practice address
146 Pike Street Outpatient Clinic Port Jervis NY 12771
Phone: (845) 858-1456
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Social Worker 104100000X 107538 New York
Behavioral Health & Social Service Providers / Clinical 1041C0700X 099243 New York

Profile Details

NPI number 1982236022
LBN Legal business name Jackson, Jylian Ann
Credentials LMSW
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 6th, 2020
Last updated Feb 19th, 2025 - about last year

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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