Eric D Jackson, PHD
Psychologist, Clinical in Orange, Connecticut
1184047698- Practice location
- 35 Old Tavern RD, Suite 103, Orange, CT 06477-3450
- Phone
- 203-701-9666
- Fax
- —
- Last updated
- February 4, 2014
Eric D Jackson is a Psychologist, Clinical based in Orange, CT. Eric D Jackson practices in Orange, CT and has the professional credentials of PHD. The NPI Number for Eric D Jackson is 1184047698 and holds a License No. 003329 (CT). The current practice location address for Eric D Jackson is 35 Old Tavern RD, Suite 103, Orange, CT 06477-3450 and can be reached out via phone at 203-701-9666.
Provider Profile Details
- NPI Number
- 1184047698
- Provider Name
- Eric D Jackson
- Credential
- PHD
- Provider Entity Type
- Individual
- Gender
- Male
- Address
- 35 Old Tavern RD, Suite 103, Orange, CT 06477-3450
- Phone Number
- 203-701-9666
- Primary Taxonomy
- Psychologist, Clinical · 103TC0700X
- Sole Proprietor
- Yes
- Provider Enumeration Date
- February 4, 2014
- Last Update Date
- February 4, 2014
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 35 Old Tavern RD
Suite 103
Orange, CT 06477-3450 - City
- Orange
- State
- Connecticut
- Zip
- 06477-3450
- Phone Number
- 203-701-9666
Provider Business Mailing Address Details
- Address
- 88 E Broadway Apt B
Milford, CT 06460-6128 - City
- Milford
- State
- CT
- Zip
- 06460-6128
- Phone Number
- 203-701-9666
License Information
- License Number
- 003329
- License State
- CT
- Taxonomy
- Psychologist, Clinical · 103TC0700X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Eric D Jackson, PHD?
The NPI number of Eric D Jackson, PHD is 1184047698. It was assigned on February 4, 2014 and is currently active in the NPPES registry.
What is the specialty of Eric D Jackson, PHD?
Eric D Jackson, PHD is registered under the primary taxonomy Psychologist, Clinical (code 103TC0700X), licensed in CT under license number 003329.
Where does Eric D Jackson, PHD practice?
The practice location is 35 Old Tavern RD, Suite 103, Orange, CT 06477-3450. The office can be reached at 203-701-9666 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1184047698 directly on the NPPES registry website.