Carla L Jackson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6776 Issued in TN

Practice address

2911 Essary Dr Ste 200
Knoxville, TN 37918-2469

Phone

(865) 371-8101

NPI assigned

Dec 12, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in DC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Merit-based Incentive Payment System (MIPS)

Final score

35.98 of 100Reported as group

Quality

0

Promoting interoperability

0

Improvement activities

20

Cost

78.28

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: carla.jackson.1@24804.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  DC

  Medicare reassignment
• Crossroads Treatment Centers of Tennessee, P.C.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Fayetteville, TN
  • NPI 1780541607
  NPD (past)

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

{
    "created_epoch": "1576108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742774400000",
    "number": "1013555770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2911 ESSARY DR STE 200",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379182469",
            "telephone_number": "865-371-8101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2911 ESSARY DR STE 200",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379182469",
            "telephone_number": "865-371-8101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "CARLA",
        "middle_name": "L",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-12",
        "last_updated": "2025-03-24",
        "certification_date": "2025-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904015665",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "6776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "carlajacksoncfs@outlook.com",
            "affiliation": "N",
            "endpointDescription": "email address",
            "address_1": "3518 Tupelo Way",
            "city": "Knoxville",
            "state": "TN",
            "country_code": "US",
            "postal_code": "379124885",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Megan C Jack, MD
• Mycah Jack, FNP-BC
• Alfred Vaughn Derise Jackson Jr., MD
• Becky L Jackson, MD
• Brittany Michelle Jackson
• Diamond Alyssia Jackson, LPN
• Elijah Jackson
• Jasmine Rena Jackson, MS
• Kacey Jackson
• Kathryn Lynelle-Tudor Jackson

• All providers in Knoxville, TN
• Clinical Social Worker in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.