Jackson, Ursula Ann

Jackson, Ursula Ann is an individual health care provider with primary practice located at 450 Forbes St , East Hartford CT 06118-1716. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Jackson, Ursula Ann can be contacted via phone (860) 622-5340.

Contact Information

Primary practice address
450 Forbes St East Hartford CT 06118-1716
Phone: (860) 622-5340
Fax: (860) 622-5342
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 006586 Connecticut

Profile Details

NPI number 1184952459
LBN Legal business name Jackson, Ursula Ann
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 25th, 2009
Last updated Dec 2nd, 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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Identifiers

StateTypeNumberIssuer
All States NPI 1184952459 NPPES
Connecticut Other 006586 LICENSE

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