Dr. Jonnie R. Jackson
Pastoral Counselor
141 Runnymede Dr
East Stroudsburg
, Pennsylvania 18301-6958
Dr. Jonnie R. Jackson
Pastoral Counselor
141 Runnymede Dr
East Stroudsburg
, Pennsylvania 18301-6958
(570) 476-4279
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About
Features
Specialties
- Pastoral Counselor
Languages spoken
- English
Location
First Address
- Dr. Jonnie R. Jackson
- 141 Runnymede Dr
- East Stroudsburg, PA
- Zip : 18301-6958
- Phone : (570) 476-4279
Second Address
- Dr. Jonnie R. Jackson
- 141 Runnymede Dr
- East Stroudsburg, PA
- Zip : 18301-6958
- Phone : (570) 476-4279
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 101YP1600X | Pastoral Counselor |
National Provider Identifier
| NPI | 1225550502 |
|---|---|
| Provider Name | Dr. Jonnie R. Jackson |
| First Address | East Stroudsburg, PA 18301-6958 |
| Second Address | East Stroudsburg, PA 18301-6958 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 08/07/2017 |
| Last Update Date | 08/07/2017 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 00000000000000000000 | (05) | PA |
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.