Organization
NATIONAL STRESS CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TIM JACKSON (DIRECTOR)
(646) 571-8627
Entity
Organization
Contact information
Practice address
1201 N ORANGE ST, SUITE 600, WILMINGTON, DE 19801-1155
(646) 571-8627
Mailing address
150 PLEASANT ST, NEWTON, MA 02459-1828
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
03127
MD
103T00000X
Psychologist
Primary
071-005431
IL
103T00000X
Psychologist
2592-057
WI
103TC0700X
Clinical Psychologist
1214
HI
1041C0700X
Clinical Social Worker
MFT (MFC) 37695
CA
Other
Enumeration date
02/02/2011
Last updated
02/02/2011
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