Provider Demographics
NPI:1154513943
Name:JACKLER, ANN (MSW CSW)
Entity type:Individual
Prefix:MS
First Name:ANN
Middle Name:
Last Name:JACKLER
Suffix:
Gender:F
Credentials:MSW CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 HARWOOD CT
Mailing Address - Street 2:SUITE 420
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583
Mailing Address - Country:US
Mailing Address - Phone:914-725-7985
Mailing Address - Fax:914-328-1789
Practice Address - Street 1:14 HARWOOD CT
Practice Address - Street 2:420
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583
Practice Address - Country:US
Practice Address - Phone:914-725-7985
Practice Address - Fax:914-328-1789
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-15
Last Update Date:2007-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR246741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
R24674OtherNY STATE LICENSURE