Jackson, Tina

Jackson, Tina is an sole proprietor health care provider with primary practice located at 150 Shelter Cove Way , Carrollton VA 23314-4167. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Jackson, Tina can be contacted via phone (757) 944-4010.

Contact Information

Primary practice address
150 Shelter Cove Way Carrollton VA 23314-4167
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 0732006392 Virginia

Profile Details

NPI number 1326753518
LBN Legal business name Jackson, Tina
Credentials BS, MAED, L-QMHP A/C
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 23rd, 2023
Last updated Jan 23rd, 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.

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