Active NPI
Sienna Jackson, LSW
- Social Worker
- Kent, OH
National Provider Identifier
1164267555
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- S.2410418
- Practice address
- 275 Martinel Dr
Kent, OH 44240-4380 - Phone
- (330) 673-6339
- NPI assigned
- Jun 27, 2024
- Last updated
- Jun 27, 2024
- Sex
- Female
- Sole proprietor
- Yes
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 | S.2410418 | OH | Primary |
Addresses
Primary practice location
275 Martinel Dr
Kent, OH 44240-4380
Mailing address
275 Martinel Dr
Kent, OH 44240-4380
Phone (330) 673-6339
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 |
|---|---|---|---|
| S.2410418 | OH | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1719446400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719446400000",
"number": "1164267555",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "275 MARTINEL DR",
"city": "KENT",
"state": "OH",
"postal_code": "442404380",
"telephone_number": "330-673-6339"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "275 MARTINEL DR",
"city": "KENT",
"state": "OH",
"postal_code": "442404380",
"telephone_number": "330-673-6339"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "SIENNA",
"credential": "LSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-06-27",
"last_updated": "2024-06-27",
"certification_date": "2024-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "OH",
"license": "S.2410418",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kent, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.