Roxanne Marie Jackson, MSW, CSWA

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

A14459 Issued in OR

Practice address

10151 SE Sunnyside Rd Ste 480
Clackamas, OR 97015-5705

Phone

(503) 739-8321

NPI assigned

Apr 5, 2023

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Western Psychological and Counseling Services LLC

  dba LifeStance Health

  • Clinical Psychologist
  • Vancouver, WA
  • NPI 1629345731
  NPD (past)

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

{
    "created_epoch": "1680652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698883200000",
    "number": "1083309108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9701 SE JOHNSON CREEK BLVD APT F108",
            "city": "HAPPY VALLEY",
            "state": "OR",
            "postal_code": "970863681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10151 SE SUNNYSIDE RD STE 480",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970155705",
            "telephone_number": "503-739-8321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "ROXANNE MARIE",
        "credential": "MSW, CSWA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-05",
        "last_updated": "2023-11-02",
        "certification_date": "2023-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "23-QMHP-R-2303",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "A14459",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dayana Jaalouk
• Alycia Wai Lin Jackson, M.D.
• Collin Patrick Jackson, MD
• Jessica Ann Jackson, L.M.T
• Kelly Elizabeth Jackson, PT, DPT
• Sean Jackson
• Jacobs Mental Health Services (Skycloud Mental Health)
• Justin Jacobs
• Madeline Jacobs, PMHNP, RN, BSN
• Paul O. Jacobs, MD

• Clinical Social Worker in Clackamas, OR
• Providers in Clackamas, OR by specialty
• Clinical Social Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2023; 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.