National Provider Identifier
Timothy William Jackson, M.A., CASAC
Timothy William Jackson, M.A., CASAC is listed in the NPPES registry with a primary specialty of Addiction (Substance Use Disorder) Counselor in Bath, NY and a listed phone number of (607) 664-2152.
Profile Overview
- NPI
- 1538485396
- Provider Type
- Individual
- Primary Specialty
- Addiction (Substance Use Disorder) Counselor
- Enumeration Date
- April 19, 2010
- Last Updated
- March 16, 2016
Practice Location
- 115 Liberty St
- Bath, NY 14810-1508
Phone: (607) 664-2152
Specialties
- Addiction (Substance Use Disorder) Counselor (101YA0400X)
Full Record
- NPI
- 1538485396
- Entity Type
- Individual
- Last Name
- Jackson
- First Name
- Timothy
- Middle Name
- William
- Name Prefix
- Mr.
- Credential
- M.A., CASAC
- Mailing Street Address
- 115 Liberty St
- Mailing City
- Bath
- Mailing State
- NY
- Mailing ZIP Code
- 14810-1508
- Mailing Country
- US
- Practice Street Address
- 115 Liberty St
- Practice City
- Bath
- Practice State
- NY
- Practice ZIP Code
- 14810-1508
- Practice Country
- US
- Practice Phone
- (607) 664-2152
- Enumeration Date
- April 19, 2010
- Last Updated
- March 16, 2016
- Sex
- Male
- Sole Proprietor
- No
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Addiction (Substance Use Disorder) Counselor (101YA0400X)