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Tony A Jackson, CDCA
Addiction (Substance Use Disorder) Counselor in Shelby, Ohio
NPI 1568968626

Tony A Jackson is an Addiction (Substance Use Disorder) Counselor based in Shelby, OH and is specialized in Addiction (Substance Use Disorder). Tony A Jackson practices in Shelby, OH and has the professional credentials of CDCA. The NPI Number for Tony A Jackson is 1568968626 and holds a License No. CDCA165157 (Ohio).

The current practice location address for Tony A Jackson is 2775 State Route 39, Shelby, OH and can be reached out via phone at 419-747-3322.

Location: 2775 State Route 39, Shelby, OH, 44875-9466
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1568968626
Provider Name
Tony A Jackson
Credential
CDCA
Provider Entity Type
Individual
Gender
Male
Address
2775 State Route 39, Shelby, OH, 44875-9466
Phone Number
419-747-3322
Fax Number
Provider Enumeration Date
04/05/2018
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
2876928 05 OH
institution
Provider Business Practice Location Address Details
Address
2775 State Route 39
City
Shelby
State
Ohio
Zip
44875-9466
Phone Number
419-747-3322
Fax Number
person
Provider Business Mailing Address Details
Address
2775 State Route 39
City
Shelby
State
Ohio
Zip
44875-9466
Phone Number
419-747-3322
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
101YA0400X
License No.
CDCA165157 (Ohio)
Definition
Definition to come...
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