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Contact Information

EBONY HARVEY JACKSON, LMSW
19323 STANSBURY ST
DETROIT, MI48235-1733
 Phone: 313-215-6395
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Technician, Health Information

247000000X
 

Clinical

1041C0700X 80 Licensed Clinical Social Worker
Indicates primary specialty

NPI Profile & details for EBONY HARVEY JACKSON · (Female)

NPI # 1164820163
Status Active
Credentials LMSW (Licensed Master Social Worker)
Entity Individual
Enumeration date 12/08/2014
Last updated 04/02/2015 - About 11 years ago
Sole proprietor 1 No
Identifiers
  • MI License # 6801085319
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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