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Contact Information

MARGUERITE JACKSON, M.ED, BCPC
7556 WOODCREST AVE
PHILADELPHIA, PA19151-2704
 Phone: 215-400-1551
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Mental Health

101YM0800X
 

Addiction (Substance Use Disorder)

103TA0400X 62 Psychologist, Clinical
 

Addiction (Substance Use Disorder)

101YA0400X
 

Health Service

103TH0100X 62 Psychologist, Clinical
 

Professional

101YP2500X
 

Psychologist

103T00000X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for MARGUERITE JACKSON · (Female)

NPI # 1053733782
Status Active
Credentials M.ED, BCPC
Entity Individual
Enumeration date 01/15/2014
Last updated 03/22/2017 - About 9 years ago
Sole proprietor 1 Yes
Identifiers
  • PA Medicaid 29692MD048189L
  • PA Other 30053142 KEYSTONE FIRST
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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