Jackson, Shannon
Jackson, Shannon is an sole proprietor health care provider with primary practice located at 150 North Main St Echn Health Services, Manchester CT 06040-4188. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Jackson, Shannon can be contacted via phone (860) 647-6832.Contact Information
Primary practice address
150 North Main St Echn Health Services
Manchester CT 06040-4188
Phone: (860) 647-6832
Fax: (860) 647-6831
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 00297 | Connecticut |
Profile Details
| NPI number | 1417281064 |
|---|---|
| LBN Legal business name | Jackson, Shannon |
| Credentials | PSY.D. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 30th, 2009 |
| Last updated | Sep 30th, 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.
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