Active NPI
Diamond Jackson, LLBSW
- Social Worker
- Detroit, MI
National Provider Identifier
1114406998
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 6852090135
- Practice address
- 882 Oakman Blvd
Detroit, MI 48238-3710 - Phone
- (313) 961-4890
- NPI assigned
- Aug 12, 2018
- 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 6852090135 | MI | Primary |
Addresses
Primary practice location
882 Oakman Blvd
Detroit, MI 48238-3710
Mailing address
22141 Whitmore St
Oak Park, MI 48237-3525
Phone (248) 828-6625
Other names 1
- Diamond Wilford
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6852090135 | MI | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1534032000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1742169600000",
"number": "1114406998",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22141 WHITMORE ST",
"city": "OAK PARK",
"state": "MI",
"postal_code": "482373525",
"telephone_number": "248-828-6625"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "882 OAKMAN BLVD",
"city": "DETROIT",
"state": "MI",
"postal_code": "482383710",
"telephone_number": "313-961-4890"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "DIAMOND",
"credential": "LLBSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-08-12",
"last_updated": "2025-03-17",
"certification_date": "2025-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MI",
"license": "6852090135",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "DIAMOND",
"last_name": "WILFORD",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.