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Individual
STEPHEN A JACKSON
Active
Individual
STEPHEN A JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LSW
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
SW134366
PA
1041C0700X
Clinical Social Worker
Primary
CW024282
PA
Other
Enumeration date
03/15/2018
Last updated
03/26/2026
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