Individual
JACKSON KENT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
3428 BRODHEAD RD, MONACA, PA 15061-3132
(724) 728-6670
Mailing address
801 23RD ST APT 7, AMBRIDGE, PA 15003-1848
(917) 538-7233
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
SW138766
PA
1041C0700X
Clinical Social Worker
Primary
CW025242
PA
Other
Enumeration date
10/30/2023
Last updated
11/12/2024
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