National Provider Identifier
Edward Jackson Jr., LMFT
Edward Jackson Jr., LMFT is listed in the NPPES registry with a primary specialty of Marriage & Family Therapist in Tonawanda, NY and a listed phone number of (716) 201-0522.
Profile Overview
- NPI
- 1649879743
- Provider Type
- Individual
- Primary Specialty
- Marriage & Family Therapist
- Enumeration Date
- October 20, 2020
- Last Updated
- September 11, 2023
Practice Location
- 1868 Niagara Falls Blvd Ste 103
- Tonawanda, NY 14150-6494
Phone: (716) 201-0522
Specialties
- Marriage & Family Therapist (106H00000X)
Full Record
- NPI
- 1649879743
- Entity Type
- Individual
- Last Name
- Jackson
- First Name
- Edward
- Name Prefix
- Mr.
- Name Suffix
- Jr.
- Credential
- LMFT
- Mailing Street Address
- 1868 Niagara Falls Blvd Ste 103
- Mailing City
- Tonawanda
- Mailing State
- NY
- Mailing ZIP Code
- 14150-6494
- Mailing Country
- US
- Mailing Phone
- (716) 201-0522
- Practice Street Address
- 1868 Niagara Falls Blvd Ste 103
- Practice City
- Tonawanda
- Practice State
- NY
- Practice ZIP Code
- 14150-6494
- Practice Country
- US
- Practice Phone
- (716) 201-0522
- Enumeration Date
- October 20, 2020
- Last Updated
- September 11, 2023
- Sex
- Male
- Sole Proprietor
- No
- Certification Date
- September 11, 2023
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Marriage & Family Therapist (106H00000X)