Tamara Jackson, LSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

23425 Issued in MN

Practice address

2562 7TH Ave E Ste 201
North St Paul, MN 55109-3037

Phone

(651) 330-2550

NPI assigned

Apr 24, 2024

Sex

Female

Sole proprietor

No

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

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

{
    "created_epoch": "1713916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713916800000",
    "number": "1053167726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2562 7TH AVE E STE 201",
            "city": "NORTH ST PAUL",
            "state": "MN",
            "postal_code": "551093037",
            "telephone_number": "651-330-2550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2562 7TH AVE E STE 201",
            "city": "NORTH ST PAUL",
            "state": "MN",
            "postal_code": "551093037",
            "telephone_number": "651-330-2550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "TAMARA",
        "credential": "LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-24",
        "last_updated": "2024-04-24",
        "certification_date": "2024-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MN",
            "license": "23425",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sawyer A Hildebrant, DC
• Ariyana Holyfield
• Emily Michelle Hudson
• Stacy Hydinger
• Matthew Gary Hyopponen, D.C.
• James G Koller DDS,PA
• Jenn Schmidt RDN LLC
• Kristine Ann Johnson, PA-C
• Svitlana Johnson, R. N.
• David R Joubert, LADC

• Social Worker in North St Paul, MN
• Providers in North St Paul, MN by specialty
• Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2024; 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.