Jackson, Marcella
Jackson, Marcella is an sole proprietor health care provider with primary practice located at 8831 Satyr Hill Rd Ste 107 , Baltimore MD 21234-2437. She recently has 5 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Social Worker, Agencies / Case Management, Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center), Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Mental Health is her primary health care specialty. Jackson, Marcella can be contacted via phone (443) 838-1700.Contact Information
Primary practice address
8831 Satyr Hill Rd Ste 107
Baltimore MD 21234-2437
Phone: (443) 838-1700
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | 18439 | Maryland |
| Behavioral Health & Social Service Providers / Social Worker | 104100000X | 18439 | Maryland |
| Agencies / Case Management | 251B00000X | 18439 | Maryland |
| Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center) | 261QM0801X | 18439 | Maryland |
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | 18439 | Maryland |
Profile Details
| NPI number | 1922716711 |
|---|---|
| LBN Legal business name | Jackson, Marcella |
| Credentials | LMSW |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 9th, 2022 |
| Last updated | Jan 7th, 2023 - about 3 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 | 1922716711 | NPPES |
| Maryland | Other | 18439 | LICENSE ID |
| Maryland | MEDICAID | 1922716711 | LICENSE ID |
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