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Contact Information

ROBERTA D JACKSON, MA COUNSELING
2316 ST MATTHEWS ROAD
ORANGEBURG, SC29118
 Phone: 803-536-1571
 Fax: 803-536-1463
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Mental Health

101YM0800X
Indicates primary specialty

NPI Profile & details for ROBERTA D JACKSON · (Female)

NPI Number 1043232655
Status Active
Credentials MA COUNSELING
Entity Individual
Enumeration date 07/24/2006
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 No
Identifiers
  • SC Medicaid 413093
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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