Active NPI
Dorothy Jane Jackson, LCSW
- Clinical Social Worker
- Cheshire, CT
National Provider Identifier
1104876374
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 000101
- Practice address
- 350 S Main St
Adolescent &Family Counseling Center
Cheshire, CT 06410-3160 - Phone
- (203) 271-1234
- Fax
- (203) 272-9094
- NPI assigned
- May 11, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 000101 | CT | Primary |
Addresses
Primary practice location
350 S Main St
Adolescent &Family Counseling Center
Cheshire, CT 06410-3160
Mailing address
350 S Main St
Adolescent &Family Counseling Center
Cheshire, CT 06410-3160
Phone (203) 271-1234
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1288076 | Other | CT | AETNA |
| 1400000101CT02 | Other | CT | BCBS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000101 | CT | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147305600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1104876374",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "350 S MAIN ST",
"address_2": "ADOLESCENT &FAMILY COUNSELING CENTER",
"city": "CHESHIRE",
"state": "CT",
"postal_code": "064103160",
"telephone_number": "203-271-1234",
"fax_number": "203-272-9094"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "350 S MAIN ST",
"address_2": "ADOLESCENT &FAMILY COUNSELING CENTER",
"city": "CHESHIRE",
"state": "CT",
"postal_code": "064103160",
"telephone_number": "203-271-1234",
"fax_number": "203-272-9094"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "DOROTHY",
"middle_name": "JANE",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-11",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CT",
"license": "000101",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "1288076",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "1400000101CT02",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cheshire, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.