Audrey Lee Jackson, MSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801105658 Issued in MI

Practice address

811 Young St
Ypsilanti, MI 48198

Phone

(734) 352-9474

NPI assigned

Jul 12, 2017

Last updated

Jun 11, 2025By the provider in NPPES

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

Enrolled in MI

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, 1978

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Catholic Social Services of Washtenaw CountyGroup PAC ID 0547288300, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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

• Catholic Social Services of Washtenaw County

  • Voluntary or Charitable Agency
  • Ann Arbor, MI
  • NPI 1679687339
  Medicare reassignment Care Compare group NPD
• Downriver Mental Health Clinic PC

  dba Lifestance Health, Inc

  • Psychologist
  • Taylor, MI
  • NPI 1295866135

  Clinical

  Medicare reassignment NPD
• Neighborhood Service Organization

  • Community/Behavioral Health Agency
  • Detroit, MI
  • NPI 1891825808
  Medicare reassignment NPD
• Pure Psychiatry of Michigan PLLC

  • Physician Assistant
  • Wayne, MI
  • NPI 1831701671
  Medicare reassignment NPD
• Thrive Counseling LLC

  dba Thriveworks

  • Mental Health Counselor
  • Lynchburg, VA
  • NPI 1215181300

  MI

  Medicare reassignment NPD
• International Therapy Solutions, PLLC

  • Clinical Social Worker
  • Warren, MI
  • NPI 1093254120
  Medicare reassignment
• Downriver Mental Health Clinic PC

  dba Advanced Counseling Services PC

  • Psychologist
  • Taylor, MI
  • NPI 1104930130

  Clinical

  NPD
• Ann Arbor Treatment Services, LLC

  • Methadone Clinic
  • Ann Arbor, MI
  • NPI 1740653641
  NPD (past)
• Arbor West Chiropractic Center P.C.

  • Chiropractor
  • Ann Arbor, MI
  • NPI 1467529453
  NPD (past)

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

{
    "created_epoch": "1499817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749600000000",
    "number": "1093237943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "811 YOUNG ST",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481984021",
            "telephone_number": "734-352-9474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 YOUNG ST",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "48198",
            "telephone_number": "734-352-9474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "AUDREY",
        "middle_name": "LEE",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-12",
        "last_updated": "2025-06-11",
        "certification_date": "2025-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801105658",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mylah Terese Ivory, LMSW
• Paul Herbert Izenberg, M.D.
• Emilohi Izirein
• J3L Care Transportation LLC
• Alexes Jackson
• Brittiny Jackson
• Christopher Jackson
• Janet Jackson
• Latia Sade Jackson
• Diane M Jacobi, OD

• Clinical Social Worker in Ypsilanti, MI
• Providers in Ypsilanti, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 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.