Faiza Omer Jackson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0904010831 Issued in VA

Practice address

300 N Washington St Ste 607
Alexandria, VA 22314-2544

Phone

(713) 933-8903

NPI assigned

Jun 28, 2011

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

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.

• Luminescence Counseling LLC

  • Clinical Social Worker
  • Alexandria, VA
  • NPI 1992267454
  NPD (past) Authorized official

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

{
    "created_epoch": "1309219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554249600000",
    "number": "1124314117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7644 AUDUBON MEADOW WAY",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223062277",
            "telephone_number": "713-933-8903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 N WASHINGTON ST STE 607",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223142544",
            "telephone_number": "713-933-8903"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "230 Venture Cir",
            "address_purpose": "LOCATION",
            "city": "Nashville",
            "state": "TN",
            "postal_code": "372281604",
            "country_code": "US",
            "telephone_number": "713-933-8903",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "FAIZA",
        "middle_name": "OMER",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-28",
        "last_updated": "2019-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IL",
            "license": "150.012194",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "23189",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904010831",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ayoka Jack
• Jeffrey A Jackman, MD
• Brittany Ann Jackson, M.D.
• Cassandra Jackson
• Emmanuel Jackson
• Gina Diane Jackson, PA-C
• Gina Lori Jackson, RN
• James Jackson, COTA/L
• Karen C. Jackson, CCC-SLP
• Kevin D Jackson, D.D.S.

• Clinical Social Worker in Alexandria, VA
• Providers in Alexandria, VA by specialty
• Clinical Social Worker in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2019; 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.