Jacob Jerry Jackson
Addiction Counselor (Substance Use Disorder)
1700 Helmer St
Sioux City
, Iowa 51103-2834
Jacob Jerry Jackson
Addiction Counselor (Substance Use Disorder)
1700 Helmer St
Sioux City
, Iowa 51103-2834
(712) 223-1082
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About
Features
Specialties
- Addiction Counselor (Substance Use Disorder)
Languages spoken
- English
Location
First Address
- Jacob Jerry Jackson
- 1700 Helmer St
- Sioux City, IA
- Zip : 51103-2834
- Phone : (712) 223-1082
Second Address
- Jacob Jerry Jackson
- 1700 Helmer St
- Sioux City, IA
- Zip : 51103-2834
- Phone : (712) 223-1082
Reviews
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) | 15081 | IA |
National Provider Identifier
| NPI | 1003366329 |
|---|---|
| Provider Name | Jacob Jerry Jackson |
| First Address | Sioux City, IA 51103-2834 |
| Second Address | Sioux City, IA 51103-2834 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 11/10/2016 |
| Last Update Date | 11/10/2016 |
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.