National Provider Identifier
Tony Jackson
Tony Jackson is listed in the NPPES registry with a primary specialty of Mental Health Counselor in Rochester, NY and a listed phone number of (585) 445-5310.
Profile Overview
- NPI
- 1073841185
- Provider Type
- Individual
- Primary Specialty
- Mental Health Counselor
- Enumeration Date
- December 01, 2009
- Last Updated
- February 24, 2023
Practice Location
- 150 Mount Hope Ave
- Rochester, NY 14620-1016
Phone: (585) 445-5310
Mailing Address
- 1526 Walden Ave
- Suite 400
- Cheektowaga, NY 14225-4965
Specialties
- Mental Health Counselor (101YM0800X)
Full Record
- NPI
- 1073841185
- Entity Type
- Individual
- Last Name
- Jackson
- First Name
- Tony
- Mailing Street Address
- 1526 Walden Ave
- Mailing Address Line 2
- Suite 400
- Mailing City
- Cheektowaga
- Mailing State
- NY
- Mailing ZIP Code
- 14225-4965
- Mailing Country
- US
- Mailing Phone
- (716) 895-6700
- Mailing Fax
- (716) 896-0318
- Practice Street Address
- 150 Mount Hope Ave
- Practice City
- Rochester
- Practice State
- NY
- Practice ZIP Code
- 14620-1016
- Practice Country
- US
- Practice Phone
- (585) 445-5310
- Enumeration Date
- December 01, 2009
- Last Updated
- February 24, 2023
- Sex
- Male
- Sole Proprietor
- No
- Certification Date
- February 24, 2023
- Taxonomies
- Mental Health Counselor (101YM0800X)