Charles Bartlett Jackson Jr, is a
Social Worker - Clinical based in Roxboro, North Carolina. Charles Bartlett Jackson Jr is licensed to practice in North Carolina (license number C007168) and his current practice location is
355 S Madison Blvd Ste C1, Roxboro, North Carolina. He can be reached at his office (for appointments etc.) via phone at
(336) 599-8366.
NPI number for Charles Bartlett Jackson Jr is 1003149048 and his current mailing address is 355 S Madison Blvd Ste C1, Roxboro, North Carolina. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1003149048.
Healthcare Provider's Profile
| Full Name | Charles Bartlett Jackson Jr |
|---|
| Gender | Male |
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| Speciality | Social Worker - Clinical |
|---|
| Location | 355 S Madison Blvd Ste C1, Roxboro, North Carolina |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1003149048
- Provider Enumeration Date: 09/09/2009
- Last Update Date: 09/06/2015
Medical Identifiers
Medical identifiers for Charles Bartlett Jackson Jr such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1003149048 | NPI | - | NPPES |
| 6112139 | Medicaid | NC | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 1513 (North Carolina) | Secondary |
| 1041C0700X | Social Worker - Clinical | C007168 (North Carolina) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Charles Bartlett Jackson Jr is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Charles Bartlett Jackson Jr,
355 S Madison Blvd Ste C1,
Roxboro, NC 27573-5485
Ph: (336) 599-8366 | Charles Bartlett Jackson Jr,
355 S Madison Blvd Ste C1,
Roxboro, NC 27573-5485
Ph: (336) 599-8366 |
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