Lucille Jackson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

RO50134-1 Issued in NY

Practice address

441 W End Ave
Suite 1B
New York, NY 10024-5326

Phone

(917) 232-7422

Fax

(718) 548-6985

NPI assigned

Dec 28, 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

Enrolled in NY

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

Specialty

Clinical Social Worker

Education

Other, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1198800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301356800000",
    "number": "1053595819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "441 W END AVE",
            "address_2": "SUITE 1B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100245326",
            "telephone_number": "917-232-7422",
            "fax_number": "718-548-6985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "441 W END AVE",
            "address_2": "SUITE 1B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100245326",
            "telephone_number": "917-232-7422",
            "fax_number": "718-548-6985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "LUCILLE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-12-28",
        "last_updated": "2011-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "RO50134-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kay Ellen Jackson, PH. D.
• Keyanna Jackson, MD
• Krystal Jackson
• Lois Ann Jackson, D.D.S.
• Lorraine Jackson, NURSE PRACTITIONER
• Lydia Christine Jackson, PH.D.
• Lynn Jackson, MS ED
• Margaret Alene Jackson, M.D.
• Marilyn M. Jackson, M.D
• Marion Louise Jackson, LMSW

• Clinical Social Worker in New York, NY
• Providers in New York, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2011; 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.