| Beth Z Jackson, Llc | |
|
6740 Jamestown Dr Alpharetta GA 30005-3030 | |
| (706) 425-8900 | |
| Not Available |
| Full Name | Beth Z Jackson, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 6740 Jamestown Dr, Alpharetta, Georgia |
| Authorized Official Name and Position | Beth Z Jackson (PSYCHOTHERAPIST) |
| Authorized Official Contact | 7064258900 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Beth Z Jackson, Llc 6740 Jamestown Dr Alpharetta GA 30005-3030 Ph: (706) 425-8900 | Beth Z Jackson, Llc 6740 Jamestown Dr Alpharetta GA 30005-3030 Ph: (706) 425-8900 |
| NPI Number | 1689039661 |
|---|---|
| Provider Enumeration Date | 12/17/2015 |
| Last Update Date | 12/17/2015 |
| Medicare PECOS PAC ID | 9133421084 |
|---|---|
| Medicare Enrollment ID | O20160108001138 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689039661 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | CSW005424 (Georgia) | Primary |
| Provider Name | Beth Z Jackson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699103242 PECOS PAC ID: 0042512998 Enrollment ID: I20160127000675 |
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