MR. DOUGLAS CLARENCE JACKSON SUBSTANCE COUNSELOR NPI 1013160316

NPI Information

  • NPI: 1013160316
  • Provider Name: MR. DOUGLAS CLARENCE JACKSON, SUBSTANCE COUNSELOR
  • Classification: Specialist - 174400000X
  • Entity Type: Individual
  • Address: 2384 ATLANTIC AVE
    BROOKLYN, NY
    ZIP 11233
  • Phone: (718) 495-0920

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NPI Details

MR. Douglas Clarence Jackson, SUBSTANCE COUNSELOR is a specialist in Brooklyn, NY. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. MR. Douglas Clarence Jackson, SUBSTANCE COUNSELOR NPI is 1013160316. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2384 ATLANTIC AVE
BROOKLYN, NY
ZIP 11233-402
Phone: (718) 495-0920
Fax: (718) 345-5468

The enumeration date for this NPI number is 10/30/2008 and was last updated on 10/30/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1174400000XSpecialistYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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