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Organization
STEPHANIE JACKMAN LCSW PLLC
Active
Organization
STEPHANIE JACKMAN LCSW PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE JACKMAN (OWNER)
(585) 861-6827
Entity
Organization
Contact information
Practice address
360 WELLINGTON AVE, ROCHESTER, NY 14619-1210
(585) 358-6827
Mailing address
360 WELLINGTON AVE, ROCHESTER, NY 14619-1210
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0349709
LCSW LICENSE
NY
Enumeration date
09/09/2020
Last updated
09/09/2020
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