Richard M Jack, LCSW-R
NPI #1801803218 in Ticonderoga, New York
Provider Information
- NPI Number
- 1801803218
- Entity Type
- Individual
- Name
- Richard M Jack, LCSW-R
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Social Worker - Clinical
- Credential
- LCSW-R
- Enumeration Date
- Aug 1, 2006
- Last Updated
- Feb 7, 2017
Practice Location
- Address
- 102 RACE TRACK RD
- City
- Ticonderoga
- State
- New York
- ZIP Code
- 12883-4004
- Phone
- (518) 585-6708
Specialties & Taxonomy Codes
| Specialty |
|---|
| Social Worker - Clinical — Clinical |
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