Individual
CHANCE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
197 DIXWELL AVE, NEW HAVEN, CT 06511-3470
(203) 500-2147
Mailing address
169 FOUNTAIN ST APT C3, NEW HAVEN, CT 06515-1931
(203) 500-2147
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
CT
Other
Enumeration date
08/05/2025
Last updated
08/05/2025
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