Crystal Jackson

Social Worker · Patchogue, NY

Individual Active NPI

NPI number 1588211692

Practice location

456 Waverly Ave
Patchogue, NY 11772-1586
Phone
(631) 447-6460

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NPI record

NPI
1588211692
Entity type
Individual (Type 1)
Enumeration date
August 22, 2019
Last updated
August 22, 2019
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Social Worker Primary 104100000X — NY
Social Worker 104100000X — —

Mailing address

1 Route 109
West Babylon, NY 11704-6207

Other practice locations (1)

  • 1 Route 109, West Babylon, NY 11704-6207 · (631) 669-5355

About Crystal Jackson

Crystal Jackson is a healthcare provider registered in the NPI registry with the primary taxonomy Social Worker (code 104100000X). The practice location is 456 Waverly Ave, Patchogue, NY 11772-1586. The NPI number 1588211692 was assigned on August 22, 2019 and the record was last updated on August 22, 2019.

Frequently asked questions

What is the NPI number of Crystal Jackson?

The NPI number is 1588211692.

What is the phone number of Crystal Jackson?

The phone number listed for the practice location is (631) 447-6460.

Where is Crystal Jackson located?

456 Waverly Ave, Patchogue, NY 11772-1586.

What is the taxonomy code for Crystal Jackson?

The primary taxonomy code is 104100000X – Social Worker; 1 more listed above.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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