Susan Jackson, MS, LCADC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

37LC00119600 Issued in NJ

Practice address

2100 Wescott Dr
HBH 5TH FL
Flemington, NJ 08822-4603

Phone

(908) 788-6401

Fax

(908) 788-6584

NPI assigned

Jan 16, 2007

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1700938438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 WESCOTT DR",
            "address_2": "HBH 5TH FL",
            "city": "FLEMINGTON",
            "state": "NJ",
            "postal_code": "088224603",
            "telephone_number": "908-788-6401",
            "fax_number": "908-788-6584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 WESCOTT DR",
            "address_2": "HBH 5TH FL",
            "city": "FLEMINGTON",
            "state": "NJ",
            "postal_code": "088224603",
            "telephone_number": "908-788-6401",
            "fax_number": "908-788-6584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "SUSAN",
        "credential": "MS, LCADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NJ",
            "license": "37LC00119600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Addiction (Substance Use Disorder) Counselor in Flemington, NJ
• Providers in Flemington, NJ by specialty
• Addiction (Substance Use Disorder) Counselor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.