Jackson, Timothy William

Jackson, Timothy William is an individual health care provider with primary practice located at 115 Liberty St , Bath NY 14810-1508. He recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as his primary health care specialty. Jackson, Timothy William can be contacted via phone (607) 664-2152.

Contact Information

Primary practice address
115 Liberty St Bath NY 14810-1508
Phone: (607) 664-2152
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X

Profile Details

NPI number 1538485396
LBN Legal business name Jackson, Timothy William
Credentials M.A., CASAC
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 19th, 2010
Last updated Mar 16th, 2016 - about 10 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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