Charles Bartlett Jackson JR.
Addiction Counselor (Substance Use Disorder) Clinical Social Worker
355 S Madison Blvd Ste C1
Roxboro
, North Carolina 27573-5485
Charles Bartlett Jackson JR.
Addiction Counselor (Substance Use Disorder) Clinical Social Worker
355 S Madison Blvd Ste C1
Roxboro
, North Carolina 27573-5485
(336) 322-6168
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About
Features
Specialties
- Addiction Counselor (Substance Use Disorder)
- Clinical Social Worker
Languages spoken
- English
Location
First Address
- Charles Bartlett Jackson JR.
- 355 S Madison Blvd Ste C1
- Roxboro, NC
- Zip : 27573-5485
- Fax : (336) 322-6168
- Phone : (336) 599-8366
Second Address
- Charles Bartlett Jackson JR.
- 355 S Madison Blvd Ste C1
- Roxboro, NC
- Zip : 27573-5485
- Fax : (336) 322-6168
- Phone : (336) 599-8366
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FAQs
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Is Charles Bartlett Jackson JR. a sole practitioner?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | 1513 | NC |
| Y | 1041C0700X | Clinical Social Worker | C007168 | NC |
National Provider Identifier
| NPI | 1003149048 |
|---|---|
| Provider Name | Charles Bartlett Jackson JR. |
| First Address | Roxboro, NC 27573-5485 |
| Second Address | Roxboro, NC 27573-5485 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 09/09/2009 |
| Last Update Date | 06/09/2015 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 6112139 | (05) | NC |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.