Individual
SUSAN JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, LCADC
Contact information
Practice address
2100 WESCOTT DR, HBH 5TH FL, FLEMINGTON, NJ 08822-4603
(908) 788-6401
(908) 788-6584
Mailing address
2100 WESCOTT DR, HBH 5TH FL, FLEMINGTON, NJ 08822-4603
(908) 788-6401
(908) 788-6584
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
37LC00119600
NJ
Other
Enumeration date
01/16/2007
Last updated
07/08/2007
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