Individual
CHRISTOPHER JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMHC
Contact information
Practice address
104-70 QUEENS BLVD, FOREST HILLS, NY 11375
(718) 275-6010
Mailing address
475 E MAIN ST, PATCHOGUE, NY 11772-3121
(516) 363-2001
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
008069
NY
Other
Enumeration date
08/18/2017
Last updated
07/21/2022
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