Christine M. Jackson, MSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LC303202 Issued in DC

Practice address

2607 Connecticut Ave NW
WTG
Washington, DC 20008-1522

Phone

(202) 293-8296

NPI assigned

Feb 1, 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

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Apr 1, 2023 through Apr 1, 2027

Medicare enrollment (NPD)

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.

• Green Ridge Behavioral Health, LLC

  • Neurology Physician
  • Rockville, MD
  • NPI 1407088339

  Clinical

  NPD (past)

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104963560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5112 CONNECTICUT AVE NW",
            "address_2": "APT. 212",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200082065",
            "telephone_number": "202-966-1130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2607 CONNECTICUT AVE NW",
            "address_2": "WTG",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200081522",
            "telephone_number": "202-293-8296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "CHRISTINE",
        "middle_name": "M.",
        "name_prefix": "Ms.",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "DC",
            "license": "LC303202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charity Weaver Jackson, LGPC, NCACII
• Charmain Jackson
• Charmelle Renee Jackson
• Chavon Jackson
• Christine Elaine Jackson
• Cinijah Jackson
• Darlene Jackson
• Daron Jackson
• Darren Wayne Jackson II, MD
• Deanna Jackson

• Clinical Social Worker in Washington, DC
• Providers in Washington, DC by specialty
• Clinical Social Worker in District of Columbia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.