Individual
CARL JACKMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
85 BROAD ST FL 6, NEW YORK, NY 10004-2794
(646) 455-1661
Mailing address
85 BROAD ST FL 6, NEW YORK, NY 10004-2794
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
102665
NY
Other
Enumeration date
01/17/2021
Last updated
01/20/2021
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