Jackson Topaz is a Peer Specialist based in Flushing, NY. Jackson Topaz practices in Coram, NY. The NPI Number for Jackson Topaz is 1245993450 and holds a License No. (New York).
The current practice location address for Jackson Topaz is 3600 Route 112, Coram, NY and can be reached out via phone at 631-920-8500.
Location: 3600 Route 112, Coram, NY, 11351-3000
Provider Profile Details
NPI Number
1245993450
Provider Name
Jackson Topaz
Credential
Provider Entity Type
Individual
Gender
Male
Address
3600 Route 112, Coram, NY, 11351-3000
Phone Number
631-920-8500
Fax Number
Provider Enumeration Date
10/15/2021
Last Update Date
03/10/2024
Provider Business Practice Location Address Details
Address
3600 Route 112
City
State
Zip
11727-4116
Phone Number
631-920-8500
Fax Number
Provider Business Mailing Address Details
Address
3600 Route 112
City
State
Zip
11727-4116
Phone Number
631-920-8500
Fax Number
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
License No.
()
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
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