DR. BRIAN JACKSON DR. AD, CAP
NPI 1215470380
Counselor - Addiction (Substance Use Disorder) in Jacksonville, FL
Active since November 22, 2016
About Dr. Brian Jackson Dr. Ad, Cap NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. BRIAN JACKSON DR. AD, CAP (NPI 1215470380) is an individual addiction (substance use disorder) provider in Jacksonville, Florida, licensed in Florida (4410) and active in the NPI registry since November 2016.
NPPES Registry Identity
NPI1215470380
Entity TypeIndividualMale
Primary Taxonomy101YA0400X
Provider Legal NameDR. BRIAN JACKSONCredential: DR. AD, CAP
Location Address3 SHIRCLIFF WAY STE 640Jacksonville, FL 32204-4787
Mailing Address3 Shircliff Way Ste 640Jacksonville, FL 32204-4787 · (904) 389-3784
Phone(904) 389-3784
Sole ProprietorYes
Enumeration DateNovember 22, 2016
✔ NPI 1215470380 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
License✔ Licensed in FL · 4410
3 SHIRCLIFF WAY STE 640, Jacksonville, FL 32204
Other Providers at the Same Location NPPES
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1215470380, enumerated as an "individual" on November 22, 2016.
The provider is located at 3 SHIRCLIFF WAY STE 640 JACKSONVILLE, FL 32204 and the phone number is (904) 389-3784.
Counselor with taxonomy code 101YA0400X and a focus in Addiction (Substance Use Disorder).
