Kim M Jackson
Clinical Social Worker
3737 Lander Road
Pepper Pike
, Ohio 44124-5712
Kim M Jackson
Clinical Social Worker
3737 Lander Road
Pepper Pike
, Ohio 44124-5712
(216) 378-3906
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About
Features
Specialties
- Clinical Social Worker
Languages spoken
- English
Location
First Address
- Kim M Jackson
- 11801 Buckeye Road
- Cleveland, OH
- Zip : 44120-2620
- Fax : (216) 378-3906
- Phone : (216) 831-2255
Second Address
- Kim M Jackson
- 3737 Lander Road
- Pepper Pike, OH
- Zip : 44124-5712
- Fax : (216) 378-3906
- Phone : (216) 831-2255
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 1041C0700X | Clinical Social Worker | S.0027712 | OH |
National Provider Identifier
| NPI | 1003126699 |
|---|---|
| Provider Name | Kim M Jackson |
| First Address | Cleveland, OH 44120-2620 |
| Second Address | Pepper Pike, OH 44124-5712 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 15/10/2010 |
| Last Update Date | 15/10/2010 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 0268768 | (05) | OH |
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.