Individual
JANET ELAINE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
161 WEST 54TH ST, SUITE 203 204, NEW YORK, NY 10019
(212) 586-4878
Mailing address
161 W 54TH ST, #803, NEW YORK, NY 10019-5322
(212) 586-4878
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
0100301
NY
103TC1900X
Counseling Psychologist
0100301
NY
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
0100301
NY
Other
Enumeration date
05/17/2007
Last updated
06/07/2013
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